• Archives of Reconstructive Microsurgery
• /
• v.4 no.1
• /
• pp.16-22
• /
• 1995

We analyzed 11 children who underwent epiphyseal transplantation to the forearm for manage growing deformity ranged from 2 years 6 months to years(average 5 years 10 months) follow-up period. Etiologies of the functional impairment of the eleven were five traumatic, three congenital and three tumorous conditions. Lesions of epiphysis were distal radius in eight patients and distal ulna in three patients. Operation was performed with removal of non-functioning or deformed epiphysis followed by transplantation of free vascularized proximal fibular epiphysis with microvascular anastomesis. Evaluation was performed radiologically and functionally. The 9(81.8%) patients showed growth of transplanted epiphysis by radiological examination during follow up. At the last follow up, average growth rate was 0.86cm per year excepts 2 cases of no growth. Active wrist motion near normal to contralateral joint was achieved in 7 patients. In other 2 patients, active joint motion was improved but weaker than contralateral joint. Complications on donor site were two transient peroneal nerve palsy which have been resolved after 2 and 5 months post operation and one valgus ankle deformity. The ankle deformity was corrected with $Langenski\"{o}ld$ operation of the dital tibiofibular fusion. At recipient site, there was one superficial infection and it was easily controlled by systemic antibiotics. Many subsequent reports have described successful nonvascularized epiphyseal transplante, but overall results have been inconsistent and unsatisfactory. Other experimental and clinical studies in the transfer of vascularized epiphyses has encourage its clinical application. We also could gel successful growth in several cases with free vascularized epiphyseal transplantation.

• Archives of Plastic Surgery
• /
• v.33 no.2
• /
• pp.175-180
• /
• 2006

Preoperative angiography is frequently used in the planning of microsurgical reconstruction for identification of vascular abnormality that influence the planning of operation. But, recently 3D CT angiography is considered as new technique that can provide detailed information about vascular anatomy as well as soft and bony tissue without the risks of invasive angiography. 3D CT angiograms were performed in 19 patients before microsurgical reconstruction for the lower extremity and hand between May of 2003 and Oct of 2004. Sixteen of the studies were of the donor site and all of 19 studies were of the recipient site. No complications were found from the 3D CT angiograms. In one case of the bone exposed open wound, the injury of anterior tibial artery was identified and the zone of injury was adequately demonstrated. With the improvement in quality of CT imaging, 3D CT angiograms may provide a favorable alternative to invasive angiography. It is capable of providing high-resolution, three dimensional vascular imaging without the need for arterial puncture and prolonged post-procedure observation. The relation among blood vessels, bones, and soft tissue is well demonstrated in 3D CT angiogram. Also The acquisition time and examination cost were considerably lower in comparison with invasive angiography. In conclusion, this study demonstrates that 3D CT angiography may provide accurate, safe, and cost-effective preoperative imaging. The 3D CT angiography with relatively low morbidity, low cost, ease of image acquisition can have an broader role in microsurgical reconstructive surgery.

• Journal of Chest Surgery
• /
• v.34 no.7
• /
• pp.566-568
• /
• 2001

WDFA(Well-differentiated fetal adenocarcinoma) histologically resembles pulmonary blastoma. It is also thought to be a subtype of pulmonary blastoma, which has differentiated epithelial features resembling the fetal lung among its epithelial features and sarcomatous features. We recently encounted a patient who underwent surgery for WDFA. A 19-year-old man had a mass shadow in the upper lobe of the left lung. The tumor was diagnosed as pulmonary blastoma as a result of fine needle aspiration biopsy, and left upper lobe lobectomy was performed. No sarcomatous features was observed on postoperative histologic assessment, and the patient was diagnosed as having WDFA. This case is reported with a discussion of the literatures.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.23 no.1
• /
• pp.71-85
• /
• 1993

The purpose of the study was to investigate the effects of the single and fractionated irradiation on the microvascular structure of the submandibular gland in rats. For this study, 90 Sprague-Dawley strain rats were irradiated to their neck region with equal split doses of 9Gy for a 4 hours interval and 15Gy single dose by 6MV X-irradiation and sacrificed on the 1st, 3rd, 7th, 14th and 27th day after irradiation. The author observed histological changes at Hematoxylin and Eosin staining and PAS staining under a light microscope, and also observed distribution and structural changes of the microvasculature in rat submandibular gland using a scanning electron microscope by forming vascular resin casting. The results were as follows: 1. In the light microscopic examination, the microvasculature was slightly dilated and decreased in number on the 1st day after irradiation, and increase in number of microvasculature was observed on the 3rd day after irradiation. And then distribution of microvasculature was markedly increased on the 7th day after iradiation, but decreased on th 14th day after irradiation again. Such changes were greater in the single irradiated group than in the fractionated irradiated group. 2. The reaction to PAS staining on glandular cell was decreased on the 1st and the 3rd day after irradiation, and recovered on the 7th day after irradiation. The reaction was decreased on the 14th day after irradiation again, and recovered on the 28th day after irradiation. Changes were more apparent in the single irradiated group. 3. In the scanning electron microscopic examination, early changes of microvasculature were decreased capillary density, dilation of conduits and meandering. Increased capillary dentsity or anastomosis due to vascular reproduction and smooth curved running were observed on the 7th and 14th day after irradiation. Decreased capillary and smooth running tendency were observed on the 28th day after irradiation again. Such changes were greater in the single irradiated group than in the fractionated irradiated group.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.2
• /
• pp.666-671
• /
• 2016

This paper introduces a device providing close local lighting to the affected part, where the operation-purpose astral lamp alone cannot shed light directly, in an operation room of hospitals or clinics, which helps clinical doctors perform safe treatment of the affected part deep inside a human body. This medical assisting lighting is a device necessary to prevent fatal operation failures, which can occur with minute operation processes, such as tumor removal or angiorrhaphy. The components, such as the light source and power supply were designed to be low power consuming and small in size, have a narrow angle lens was used to increase the light spreading effect and focused illumination. The end-caps of the light transmission device using an optical cable and the lighting device were designed in the waterproof type to enable disinfection of these devices after use for the next patients. According to the measurement of the light source properties made after development of the retractor lighting device, the illumination intensity was 490 lux, the brightness was $11,550cd/m^2$, general color rendering index was 78, color temperature was 11,000K, and the intensity distribution was even, which were confirmed to be adequate for medical assisting local lighting.

• Journal of Chest Surgery
• /
• v.26 no.6
• /
• pp.441-451
• /
• 1993

Protective effect of superoxide dismutase[SOD] and substrates on acute ischemic and reperfused myocardium was assessed by cardiac microdialysis. 30 Rabbits were divided into 4 groups; normal control group [group I, n=5], ischemic group [group II, n=5], SOD treated group [group III, n=10], and substrates treated group [group IV, n=10]. After a microdialysis apparatus was implanted in rabbit myocardium, coronary artery was occuluded for 5 minutes and reperfusion was performed for 30 minutes. Hemodynamic changes, CK-MB isoenzyme level and adenine ring compound level in effluent dialysates [equilibrated with interstitial fluid], and ultrastructural changes of myocardial cell were analysed. Systolic blood pressure at 10 and 30 minutes after reperfusion was higher in group III and IV than in group II [p<.05]. Also percent recovery of systolic blood pressure in group III [p<.01] and IV [p<.02] was higher than in group II. CK-MB isoenzyme level in effluent dialysates was peaked at 10 minutes after reperfusion, thereafter decreased in group II, III and IV. At 30 minutes after reperfusion, its level was lower in group III and IV than in group II[p<.05]. Adenine ring compound level in effluent dialysates increased till 10 minutes after reperfusion and progressively decreased. At 10 and 30 minutes after reperfusion, its level was lower in group III and IV than in group II without significance. Degree of myocardial damage was estimated by scoring of mitochondrial injury. Group I was within normal range and most severe injury was seen in group II. And the score of mitochondrial injury in group III and IV was lower than in group II. In conclusion, SOD and substrates[KMP solution] had protective effect on stunned myocardium. The microdialysis appratus was a good device for studying stunned myocardium, and cardiac microdialysis might be a unique technique for analysis of regional intramyocardial interstitial fluid.

• Journal of Chest Surgery
• /
• v.30 no.4
• /
• pp.445-448
• /
• 1997

Percutaneous transthoracic fine needle biopsy has been widely used In the diagnosis of pulmonary lesions especially lung cancer. Onc of the rarest complication's is that malignant cells are implanted within the needle tract and developed a chest wall mass subsequently. Wc expcrlenccd a case of chest wall implantatio of lung cancer after percutaneous transthoracic floe needle biopsy. A 65-ycar old man had undergone bilobectomy (right upper lobe and right middle lobe)for squamous cell (·4rcinoma (TINOMO) of the lung. 60 days after percutaneous biopsy (48 days after operation), a tiny nodule (1 mm sized) was notcd at the right anterior chcst wall where the diagnostic fine needle biopsy had been performed before operation. This tiny mass was rapidly growing to 1.5 cm sized mass for 20 days. We carried out wide excision of chest wall mass and skin grafting, and confirmed squamous cell carcinoma histopathologically as same as the lung cancer.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.2
• /
• pp.101-106
• /
• 2004

Purpose : This study evaluated the effect of VEGF in the arterial anastomosis by using light and electron microscopy. Marerials and method : Rats underwent femoral arterial end-to-end anastomosis after transection and topical VEGF treatment. The proximal and distal segments of the femoral arteries was drenched with 1 drop of VEGF $(100ng/100{\mu}l/bottle)$. and when half of the repair was finished, the other 1 drop was drenched and then the repair was continued to complete the anastomosis. Gross and histologic characteristics of arterial wall were assessed after 3 days, 1, 3 and 5 weeks. In the control group, normal saline solution instead of VEGF was dropped with the same method in the anastomosis. Results : The histologic findings of the arterial wall were the vascular remodeling with the infiltration of inflammatory cells at early stages and the tissue fibrosis at lately stages in the anastomotic sites of the control and the VEGF-treated groups. The scanning electron microscopic results were; (1) the anastomotic sites were covered by many irregular cells with long cytoplasmic processes at the early stages. (2) After 1 week, endothelial cells started to cover the anastomotic sites. (3) After 3 weeks, the anastomotic sites were partially covered by endothelial cells in the control group. (4) After 5 weeks, the anastomotic sites were completely covered by endothelial cells in the control and VEGF-treated groups. (5) In the VEGF-treated group, the anastomotic site was completely covered by endothelial cells which directed parallel to longitudinal axis of arteries after 3 weeks. Conclusion : Topical VEGF maintained luminal integrity by decreasing fibrosis and increasing re-endothelialization. These findings suggest that topical VEGF may be a promising new strategy to enhance healing and improve the outcome of vascular anastomosis.

• Journal of Animal Science and Technology
• /
• v.48 no.2
• /
• pp.191-202
• /
• 2006

In addition to the removal of dying or dead lutein cells by phagocytosis in many species, macrophages exert both luteotropic effect during maturation period and luteolytic effect during degenerative period via mediating autocrine/paracrine actions of self-producing cytokines in the corpus luteum. In this experiment, immunohistochemical and transmission electron microscopic (TEM) studies were performed to observe the morphologic changes of luteal macrophages during luteolysis. A small number of macrophages and low immunoreactivity were present at the mature stage. The number of macrophages and immunoreactivity gradually increased along the advance of luteolysis. Two subtypes of macrophages could be observed through TEM observation. One type of macrophage located between the large lutein cells contained no lipid droplets in their cytoplasm at mature stage. The other type of macrophage located near the blood vessels contained many lipid droplets in their cytoplasm during luteolysis. Particularly, no phagocytic macrophages were observed, which suggested the macrophages in the porcine corpus luteum did not involve in the phagocytotic elimination of dying lutein cells.

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.97-107
• /
• 1999

The osteogenic capacity of the vascularized periosteum autograft has been extensively demonstrated by experimental works. The objective of this study was to characterize the behavior of experimental model of vascularized periosteal flap(VPF) by observing sequential stages of osteogenesis after simulated VPF in rabbits. In experimental group, segmental resection of bone including the periosteum was performed in 22 radii of 22 New Zealand white rabbits preserving the periosteal circulation of median artery to the periosteum. In order to simulate the transplantation of VPF, the vascular pedicle consisting of median artery and veins was dissected from adjacent soft tissue and the periosteum was longitudinally incised to remove the bone followed by repair of the periosteum. From the first to sixteenth week after the simulated VPF, the changes in VPFs were observed by radiological, light microscopical, scanning electron microscopical methods and the activity of osteocalcin was measured by immunohistochemical method. In control group, the bone tissue and periosteum were completely removed from the mid-shaft of radius and the findings were observed by radiological and light microscopical methods. From the results of this study, it is demonstrated that the experimental model of VPF is vigorously and uniformly osteogenic. Therefore it is thought that VPF can be used as a measure to treat bone defect of shaft of long bone.