• Title/Summary/Keyword: lateral branch

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Reliability of the Anterior Thigh Free Flap for Reconstruction of the Extremities (상하지 재건을 위한 유리피판 공여부로서 전측대퇴부의 신뢰성)

  • Park, Ji-Ung;Cho, Sang-Hun;Eo, Su-Rak
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.39-47
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    • 2007
  • With the advent of microsurgery, perforator free flap is nowadays considered the first choice for reconstruction of the extensive defect of the extremities because of their moderate thickness. Among them, anterior (anterolateral and anteromedial) thigh perforator free flaps provide the first choice for reconstruction of various soft tissue defects of the extremities with many advantage such as its large, uniform thickness, long vascular pedicle with proper vessel size and minimal donor site morbidity. But, it has still some criticism of unreliable perforators which makes us very careful in elevating the flap. Between March of 2006 and February of 2007, we treated 7 patients of soft tissue defects in the hand and lower extremities with anterior thigh perforator free flap at Hallym and DongGuk University Hospital. We performed 6 anterolateral thigh perforator free flaps based on the descending branch of lateral circumflex femoral artery (LCFA) and 1 anteromedial thigh perforator free flap based on the innominate branch of the LCFA. While approaching for the anterolateral thigh free flap, we happen to meet the cases which we should change into the anteromedial thigh free flap uneventfully on the operating field. In contrast to the original design of anterolateral thigh free flap, we had to harvest the anteromedial thigh perforator free flap in 1 case. All the anterior thigh perforator free flaps survived completely except 1 case of partial necrosis due to venous congestion. Donor sites were closed primarily and healed uneventfully within 2 weeks. Patients were satisfied with the functionally and aesthetically acceptable results. Although doppler sonography is strongly recommended preoperatively in planning the anterior thigh perforator free flaps, we should always remember the variation in vascular anatomy and be ready to change the flap choice from the anterolateral to anteromedial intraoperatively. we provide a review of the literature and present our series of anterior thigh perforator free flaps for reconstruction of the extremities.

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Surgical implications of anatomical variation in anterolateral thigh flaps for the reconstruction of oral and maxillofacial soft tissue defects: focus on perforators and pedicles

  • Kim, Ji-Wan;Kim, Dong-Young;Ahn, Kang-Min;Lee, Jee-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.265-270
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    • 2016
  • Objectives: To gain information on anatomical variation in anterolateral thigh (ALT) flaps in a series of clinical cases, with special focus on perforators and pedicles, for potential use in reconstruction of oral and maxillofacial soft tissue defects. Materials and Methods: Eight patients who underwent microvascular reconstructive surgery with ALT free flaps after ablative surgery for oral cancer were included. The number of perforators included in cutaneous flaps, location of perforators (septocutaneous or musculocutaneous), and the course of vascular pedicles were intraoperatively investigated. Results: Four cases with a single perforator and four cases with multiple perforators were included in the ALT flap designed along the line from anterior superior iliac spine to patella. Three cases had perforators running the septum between the vastus lateralis and rectus femoris muscle (septocutaneous type), and five cases had perforators running in the vastus lateralis muscle (musculocutaneous type). Regarding the course of vascular pedicles, five cases were derived from the descending branch of the lateral circumflex femoral artery (type I), and three cases were from the transverse branch (type II). Conclusion: Anatomical variation affecting the distribution of perforators and the course of pedicles might prevent use of an ALT free flap in various reconstruction cases. However, these issues can be overcome with an understanding of anatomical variation and meticulous surgical dissection. ALT free flaps are considered reliable options for reconstruction of soft tissue defects of the oral and maxillofacial area.

"Mini-Flow-Through" Deep Inferior Epigastric Perforator Flap for Breast Reconstruction with Preservation of Both Internal Mammary and Deep Inferior Epigastric Vessels

  • Satake, Toshihiko;Sugawara, Jun;Yasumura, Kazunori;Mikami, Taro;Kobayashi, Shinji;Maegawa, Jiro
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.783-787
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    • 2015
  • This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.

'Redvita': A Yellow-fleshed Kiwifruit with Red Color Around the Core

  • Kwack, Yong-Bum;Kim, Hong-Lim;Lee, Jae-Han;Chung, Kyeong-Ho;Chae, Won Byoung
    • Horticultural Science & Technology
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    • v.35 no.3
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    • pp.387-391
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    • 2017
  • Kiwifruits introduced to Korea typically have green fruit flesh, yellow flesh, or yellow flesh with red coloration around the core. Here, we describe a new cultivar called 'Redvita', the first kiwifruit cultivar of Korea with yellow flesh and red coloration around the core. A conventional field cross was conducted in 2003, and permission for the final release of 'Redvita' was obtained in 2012. 'Redvita' originates from 'Red Princess', a maternal vine known for the red coloration in its flesh. The pollinizer is 'NHK0013' (IT233175), which blooms in early May. A principal feature of 'Redvita' is its high vitamin C content, which at an average of 140 mg per 100 g of fresh weight is 2 - 4 times higher than other commercial cultivars. The average fruit weight is 97 g; bigger than that of the control cultivar 'Hongyang'. 'Redvita' blooms in mid-May and is usually harvested in early to mid-October, approximately 150 - 160 days after anthesis. 'Redvita' produces 3 or 4 flowers per fruiting shoot, with no small lateral flowers, therefore does not need to be thinned before blooming for commercial production. The cultivar is acidulous because of a high titratable acidity content (about 1.5%), which is higher than other cultivars (less than 1.0%). 'Redvita' was registered with the Korean Seed and Variety Service in 2015 for plant variety protection rights (no. 5604).

Rooting Ratio of Hemp Varieties (대마 품종의 삽목 증식율)

  • 권병선;김상곤;정동희
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2001.11b
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    • pp.35-42
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    • 2001
  • In order to obtain basic information for pure line breeding of hemp which is effective on the pure line preservation and propagation, three varieties were investigative from 1995 to 1996 at Mokpo Experiment Station, Honam Agriculture Experiment Station, and cutting parts, cutting times, cutting length and storage duration after cutting of plant were observed. Higher rooting ratio were observed in cutting of shoot and later branch, in July 5, optimum harvesting time and 5 days after harvesting time, in shorter storage duration,0 and 2 days. Also there were the highest rooting ratio increased by from 12% to 16% in shorter cutting of 10cm than 15cm long cutting in shoot, lateral branch and stem cuttings. Hemp cv. Korea showed higher rooting ratio than the other varieties, Japan and Turkey. Therefore, it was concluded that hemp, a dioecious plant, could be effectively propagated for the pure lines by cutting method, especially in cv. Korea.

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Effects of Shading on Growth of 1-year-old Cornus controversa H$_{EMSL}$, Seedlings (피음이 층층나무 1년생 유묘의 생장에 미치는 영향)

  • 최재형;홍성각;김종진
    • Journal of Korea Foresty Energy
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    • v.19 no.1
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    • pp.20-29
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    • 2000
  • This study was carried out to investigate the effects of shading on the growth of 1 -year-old seedlings of Cornus controversa. The height growth was highest in relative light intensities of 100% and 50%, but relative growth rate in 50% was higher than that in 100% treatment. The growth did not occur under 9% relative light intensity. The root collar diameter growth at different light intensities is similar to height growth. The leaf area was highest in 50% relative light intensity, and the leaf area under the light intensity was small compared with the control. SLA and LAI of seedlings increased with decreasing relative light intensity. The LAR and LWR of seedlings increased with decreasing light intensity, but LWR decreased at 9% relative light intensity. The dry weight of root, stem, leaf and branch, and the number of branch and leaf decreased with decreasing relative light intensity. T/R ratio was highest in 17% and 30% relative light intensity. Lateral root growth decreased with decreasing light intensity except for that in 50% light intensity.

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Sustantial Observation on Foot Taeyang Meridian Muscle in Human Lower Limb from a Anatomical Viewpoint

  • Park, Kyoung-Sik
    • Journal of Pharmacopuncture
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    • v.12 no.2
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    • pp.21-29
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    • 2009
  • Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle) in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1) Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2) Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM) in human anatomy.

Efficient parameters to predict the nonlinear behavior of FRP retrofitted RC columns

  • Mahdavi, Navideh;Ahmadi, Hamid Reza;Bayat, Mahmoud
    • Structural Engineering and Mechanics
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    • v.70 no.6
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    • pp.703-710
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    • 2019
  • While fiber-reinforced plastic (FRP) materials have been largely used in the retrofitting of concrete buildings, its application has been limited because of some problems such as de-bonding of FRP layers from the concrete surface. This paper is the part of a wide experimental and analytical investigation about flexural retrofitting of reinforced concrete (RC) columns using FRP and mechanical fasteners (MF). A new generation of MF is proposed, which is applicable for retrofitting of RC columns. Furthermore, generally, to evaluate a retrofitted structure the nonlinear static and dynamic analyses are the most accurate methods to estimate the performance of a structure. In the nonlinear analysis of a structure, accurate modeling of structural elements is necessary for estimation the reasonable results. So for nonlinear analysis of a structure, modeling parameters for beams, columns, and beam-column joints are essential. According to the concentrated hinge method, which is one of the most popular nonlinear modeling methods, structural members shall be modeled using concentrated or distributed plastic hinge models using modeling parameters. The nonlinear models of members should be capable of representing the inelastic response of the component. On the other hand, in performance based design to make a decision about a structure or design a new one, numerical acceptance should be determined. Modeling parameters and numerical acceptance criteria are different for buildings of different types and for different performance levels. In this paper, a new method was proposed for FRP retrofitted columns to avoid FRP debonding. For this purpose, mechanical fasteners were used to achieve the composite behavior of FRP and concrete columns. The experimental results showed that the use of the new method proposed in this paper increased the flexural strength and lateral load capacity of the columns significantly, and a good composition of FRP and RC column was achieved. Moreover, the modeling parameters and acceptance criteria were presented, which were derived from the experimental study in order to use in nonlinear analysis and performance-based design approach.

Radius Intermedius Stenosis Induced Myocardial Perfusion Defect: Provened by the Fusion Images of Myocardial Perfusion SPECT and 64 Channel CTA (심근관류 SPECT와 64채널 전산화 단층혈관 촬영 사진 융합으로 증명된 radius intermedius 협착에 의한 심근관류 저하)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Park, Jong-Seon
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.77-78
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    • 2008
  • A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of $^{99m}Tc$-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

ANTEROLATERAL THIGH FLAP FOR HEAD AND NECK RECONSTRUCTION : ANATOMIC STUDY (두경부재건을 위한 전외측 대퇴유리피판: 해부학적 연구)

  • Park, Joo-Yong;Park, Hyun-Do;Youn, Kwan-Hyun;Kwak, Hyun-Ho;Hu, Kyung-Seok;Kang, Hyun-Joo;Kim, Hee-Jin;Choi, Sung-Weon
    • 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.