• Archives of Plastic Surgery
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• 제36권2호
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• pp.242-246
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• 2009

Purpose: The majority of nasal bone fractures have been managed by routine procedure of closed reduction and intranasal packing. However, nasal packing can cause nasal injury, hypoxia and patient's discomfort. And, synechiae formation is a frequently occurred after the nasal surgery. Various methods are used to reduce the incidence of synechiae formation. The purpose of this study was to compare routine procedure and nasal packing with reverse "U" shaped silicone sheet with respect to postoperative nasal synechiae formation and final outcome. Methods: We analyzed the medical records of 100 patients with nasal bone fracture who were operated by closed reduction in the last one year. The silicone sheet was designed in reverse "U" fan - shape and inserted between the middle turbinate and the septal wall. Nasal packing was removed at two days after the operation, and silicone sheet was removed at 10 to 14 days. Results: Synechiae in the middle meatus developed in 2 of 75 patients. Although synechiae between the middle meatus and nasal septum occurred in patients, the patients did not complaint of any olfactory disturbance and nasal obstruction. Conclusion: The reverse "U" fan - shape silicone sheet caused less pain for patients and no significant differences in outcome were found. The results of this study suggest that insertion of silicone sheet between the middle meatus and septum can be a useful method in the prevention of intranasal synechiae formation. The reverse "U" silicone sheet is a good alternative for routine packing methods.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.222-228
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• 2018

Background The most common surgical treatment for paralytic lagophthalmos is the placement of a weight implant in the upper eyelid; however, this technique confers the risks of implant visibility, implant extrusion, and entropion. In this study, we present a new technique of placing platinum weight implants between the levator aponeurosis and inner septum to decrease such complications. Methods A total of 37 patients with paralytic lagophthalmos were treated between March 2014 and January 2017 with platinum weight placement (mean follow-up, 520.1 days). After dissecting through the orbicularis oculi muscle, the tarsal plate and levator aponeurosis were exposed. The platinum weights (1.0-1.4 g) were fixed to the upper margin of the tarsal plate and placed underneath the orbital septum. Results Five patients could partially close their eye after surgery. The average distance between the upper eyelid and the lower eyelid when the eyes were closed was 1.12 mm. The rest of the patients were able to close their eye completely. Three patients patient developed allergic conjunctivitis after platinum weight insertion, which was managed with medication. None of the patients complained of discomfort in the upper eyelid after surgery. Visibility or extrusion of the implant were observed in three patients. Conclusions Postseptal weight placement is a safe and reproducible method in both primary and secondary upper eyelid surgery for patients with paralytic lagophthalmos. It is a feasible method for preventing implant visibility, implant exposure, and entropion. Moreover, platinum is a better implant material than gold because of its smaller size and greater thinness.

• Journal of Cardiovascular Imaging
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• 제30권2호
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• pp.125-134
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• 2022

BACKGROUND: To assess the interventricular septum (IVS) volume of fetuses from pre-gestational diabetes mellitus (DM) pregnant women by 3-dimensional ultrasound using spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) methods. METHODS: This was a prospective cross-sectional study of 45 fetuses from pre-gestational DM and 45 fetuses from healthy pregnant women (controls). Only singleton pregnancies between 20 and 34 + 6 weeks of gestation were included. The fetal IVS volumes were obtained off-line using STIC and VOCAL methods. To analyze differences among variables, the Student's t-test and Mann-Whitney U test were used. The correlation among continuous variables was determine using Spearman's correlation test (r). RESULTS: The median of fetal IVS volume was significantly higher in pre-gestational DM than in healthy pregnant women (0.3 cm³ vs. 0.2 cm³, p = 0.032). A strong positive correlation was observed between fetal IVS volume and gestational age at the time of ultrasound examination (r = 0.75, R² = 0.48, p < 0.0001) and between fetal IVS volume and estimated fetal weight (r = 0.63, R² = 0.37, p < 0.0001). No significant correlation was noted between fetal IVS volume and glycated hemoglobin levels (r = -0.16, R² = 0.01, p = 0.540) in the pre-gestational DM pregnant women. CONCLUSIONS: Significant differences were observed in fetal IVS volumes between pre-gestational and healthy mothers, with higher values in the fetuses of pre-gestational DM pregnant women.

• Anatomy and Cell Biology
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• 제55권4호
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• pp.475-482
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• 2022

Solitary distal vaginal atresia is generally caused by a transverse septum or an imperforate hymen. We found a novel type of distal vaginal atresia in a late-term fetus (gestational age approximately 28 weeks) in our histology collection. This fetus had a vaginal vestibule that was closed and covered by a thick subcutaneous tissue beneath the perineal skin in the immediately inferior or superficial side of the imperforate hymen. The uterus, uterine tube, anus, and anal canal had normal development. The urethral rhabdosphincters were well-developed and had a normal topographical relationship with the vagina, but the urethrovaginal sphincter was absent. Thus, vaginal descent seemed to occur normally and form the vestibule. However, the external orifice of the urethra consisted of a highly folded duct with hypertrophied squamous epithelium. Notably, the corpus cavernosum and crus of the clitoris had poor development and were embedded in the subcutaneous tissue, distant from the vestibule. Normally, the cloacal membrane shifts from the bottom of the urogenital sinus to the inferior aspect of the thick and elongated genital tubercle after establishment of the urorectal septum. Therefore, we speculate there was a failure in the transposition of the cloacal membrane caused by decreased elongation of the genital tubercle. The histology of this anomaly strongly suggested that the hymen does not represent a part of the cloacal membrane, but is instead a product that appears during the late recanalization of the distal vagina after vaginal descent. The transverse septum was also likely to form during this recanalization.

• Journal of Plant Biology
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• 제36권4호
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• pp.345-355
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• 1993

한국산 두릅나무과 식물 7속 11종의 목부해부학적 형질을 비교관찰하여 속간 목부의 특수화 정도를 검토하였다. 송악속은 산공재로서, 각상도관이 집합배열하고, 도관끝벽은 단천공이고 측벽은 호생벽공이었으며 방사조직은 오직 횡주세포로 구성된 동성 II형이었다. 황칠나무속은 환공재이며 각상의 추재부 소 도관들은 접선대상배열, 단천공 및 호생벽공의 특징을 보였고 방사조직에 간혹 수평수지도가 내재된 이성 II형이었다. 팔손이속은 산공재이고 각상도관이 접선대상배열이고, 계문상천공, 계문상 벽공 및 측벽에 나선비후가 나타났으며, 방사조직은 이성 II형이었다. 음나무속은 환공재이고, 환상의 소 도관은 접선대상배열이며, 단천공 및 호생벽공 그리고 이성 II형의 방사조직이 나타났다. 그 중 음나무는 도관내 격벽의 형태를 갖는 진충체를 가졌으나, 가는잎음나무에서는 격벽의 형태를 찾아 볼 수 없었다. 땃두릅나무속은 환공재이며 각상도관이 접선대상배열이고, 단천공 및 계문상 벽공 그리고 격벽형태를 갖는 진충체가 나타났으며 방사조직은 직립세포로만 구성된 paedomorphic type I이었다. 오갈피나무속은 산공재이며 각상도관이 접선대상배열, 단천공 및 호생벽공의 특징을 보였다. 본 속에서 오갈피나무는 이성 II형의 방사조직과 이관유조직 그리고 격벽형태를 갖는 진충차가 나타났다. 가시오갈피는 직립세포로만 구성된 paedomorphic type I의 방사조직과 격벽형태인 진충체가 나타났다. 섬오갈피와 오가나무는 이성 II형의 방사조직이 나타났으나, 진충체는 없었다. 두릅나무속은 환공재이고 환상도관이 접선대상배열, 단천공과 호생벽공, 그리고 격벽형태와 망상구조를 한 진충체가 나타났고, 이성 II형의 방사조직도 보였다. 도관요소의 배열, 모양, 길이, 직경 및 천공판의 각도와 방사조직의 형태 등에 의한 이들 특수화 순서는 가장 원시적인 팔손이속으로부터, 송악속, 오갈피나무속, 땃두릅나무속, 황칠나무속, 음나무속 그리고 두릅나무속 순으로 사료된다.

• Applied Microscopy
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• 제17권1호
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• pp.98-114
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• 1987

Degranulation of the rat peritoneal mast cell induced by intraperitoneal injection of horseradish peroxidase(HRP) was studied using light and electron microscopes. 1. Rat peritoneal mast cells in the Tyrode's buffered salt solution injected control group did not show any particular morphological changes following the specified time course. 2. Under the light microscope, the majority of mast cells observed 10 minutes after HRP injection were nearly the same as those of the control group. However, after 30 minutes, granule densities or staining properties of certain cells began to decrease and these appearances increased gradually until 12 hours after injection, at which time small groups of granules being stained pale-red or pink with toluidine blue were easily identified in the cytoplasm of many cells, and numerous extruded granuleg were scattered around these cells. 3. In the mast cells representing the early stage of degranulation induced by HRP, the electron densities of certain granules decreased as the size enlarged, and perigranular cavities were formed by perigranular membrane expansion. As a result, a thin cytoplasmic septum was formed between the expanded perigranular membrane and the cytoplasmic membrane in the cell periphery, and fusion of the adjacent perigranular membranes was observed in the inner side of the cell. 4. In some mast cells, one or two changes in the peripheral cytoplasmic septum could be seen. One was a focal rupture of the peripheral septum and the other was the formation of a saccule containing one or more vesicles. This saccule was thought to be used for granule-extrusion site and/or material absorptive apparatus judging from the morphological characteristics. 5. As the degranulation proceeded, the granule was extruded from the cell after partial rupture of the peripheral cytoplasmic septum. This phenomenon proceeded to-ward the inner side of the cell through the fused perigranular cavities, and consequently several distinct cavities containing a few unextruded membrane-free granules were formed throughout the cytoplasm after 12 hours. As a rule, the granule-extrusion sites were relatively fewer while the cytoplasmic cavities resulting from degranulation were more numerously observed. Thus, it was thought that the granule-extrusion sites tended to be restricted in the HRP-induced degranulation.

• 한국미생물학회:학술대회논문집
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• 한국미생물학회 2002년도 추계학술대회
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• pp.162-172
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• 2002

Schizosaccharomyces pombe is suited for the study of cytokinesis as it divides by forming a septum in the middle of the cell at the end of mitosis. To enhance our understanding of the cytokinesis, we have carried out a genetic screen for temperature-sensitive S. pombe mutants that show defects in septum formation and cell division. Here we present the isolation and characterization of a new temperature-sensitive mutant, sun1(septum uncontrolled), which undergoes uncontrolled septation during cell division cycle at restrictive temperature $(37^{\circ}C)$. In sun1 mutant, actin ring and septum are positioned at random locations and angles, and nuclear division cycle continues. These observations suggest that the sun] gene product is required for the proper placement of the actin ring as well as precise septation. The sun] mutant is monogenic recessive mutation unlinked to previously known various cdc genes of S. pombe. In a screen for $sunl^+$ gene to complement the sun] mutant, we have cloned a gene, $susl^+$(suppressor of sun1 mutant), that encodes a protein of 689 amino acids. The predicted amino acid sequence of $susl^+$ gene is similar to the human hMadlp and Saccharomyces cerevisiae Mad1p, a component of the spindle checkpoint in eukaryotic cells. The null mutant of $susl^+$ gene grows normally at various temperatures and has the increased sensitivity to anti-microtubule drug, while $susl^+$ mutant shows no sensitivity to microtubule destabilizing drugs. The putative S. pombe Sus1p directly interacts with S. pombe Mad2p in yeast two-hybrid assays. These data suggest that the newly isolated susr gene encodes S. pombe Mad1p and suppresses sun] mutant defective in controlled septation in a cell division cycle.

• Journal of Chest Surgery
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• 제39권10호
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• pp.775-778
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• 2006

비후형 심근증은 심근의 부적절한 비대로 유발되며 호흡곤란, 흉통, 실신, 그리고 급사에 이르기까지 다양한 임상 양상을 보인다. 이러한 증상은 주로 좌심실유출로의 협착으로 인해 발생하며 이를 해결하기 위해 심실중격절제술이 고안되었다. 하지만 기존의 고전적인 중격절제슬은 대동맥절개술을 통해 진행되었으며, 이는 심실 중격의 중앙부위에 병변이 존재할 경우 시야 확보의 어려움과 병변으로의 접근이 용이하지 않아 극히 일부분의 심실중격절제술만을 시행할 수밖에 없었다. 따라서 좌심실 유출로의 협착 및 승모판막의 수축기전방운동 등이 완벽하게 해결되지 않는 경우가 흔하였고 이러한 경우 환자의 증상 호전과 생존기간의 연장에도 한계가 있었다. 본 증례에서는 이러한 환아에게서 좌심실 심첨부의 절개를 통해 비후된 유두근과 건삭을 포함한 광범위 중격절제술(extended septal myectomy)을 시행하였다. 수술 후 환아의 증상은 호전되었으며 심초음파 및 방사선학적 소견상 특별한 문제없이 10개월째 외래 경과 관찰 중이다.

• Journal of Chest Surgery
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• 제12권3호
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• 제12권3호
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.