• 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.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.710-719
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• 1997

Aucubin, an iridoid glucoside, which is isolated from Aucuba japonica, has some biological effects. This study was to investigate the effect of aucubin on the remainig pulp tissues after pulpotomy. Mongrel dog's coronal pulps were mechanically exposed with a sterile round bur and excised with sterile sharp excarvator. After bleeding was controlled, in control group, $Ca(OH)_2$ powder was applied on the remaining pulps and the cavities were sealed with Z.O.E. cement. In experimental group 1, mixed powder with $Ca(OH)_2$ and aucubin(l : 1 by weight) was applied on the pulpotomized pulp surfaces. After the cavities were covered with sterile aluminum foil, they were sealed with Z.O.E. cement. In experimental group 2, only aucubin powder was applied on the remaining pulps and then they were treated the same as experimental group 1. In the all groups, the pulps were histopathologically observed by light microscope at the time intervals of 1, 2 and 4 weeks after experiment. The results were as follows : 1. In control and experimental groups, mild vascular congestion and bleeding were found in most of the specimens. Less inflammatory infiltration was observed in experimental groups than in control group. 2. Dentin bridge formation was found after 1 week at both control and experimental group 1. Dentin birdge had discontinuous osteodentin like appearance or contained some dentin chips. In experimental group 2, dentin bridge was not seen. 3. The coagulation necrosis layer on the remaining pulp tissues was seen in all groups. In experimental group 2, the thickest layer was observed. And in control group, coagulation necrosis layer was similar as in experimental group 1.

• Korean Journal of Audiology
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• v.23 no.4
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• pp.210-213
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• 2019

The auricle is a three-dimensional cartilaginous frame covered with thin overlying skin. Due to its complex features, reconstructing helical rim defects after the excision of an auricular mass is challenging. Shortage of subcutaneous tissue and the presence of a tightly bound epithelium further hamper the primary closure of lateral (anterior) auricular skin defects. We present herein a case in which we used a helical rim advancement flap along with an additional postauricular skin flap. We achieved a satisfactory esthetic result with minimal loss of helical diameter and a low risk of flap necrosis by preserving the vascular network of the flap. This technique is less traumatic and will facilitate faster healing as well as improved patient recovery.

• Journal of Audiology & Otology
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• v.23 no.4
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• pp.210-213
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• 2019

The auricle is a three-dimensional cartilaginous frame covered with thin overlying skin. Due to its complex features, reconstructing helical rim defects after the excision of an auricular mass is challenging. Shortage of subcutaneous tissue and the presence of a tightly bound epithelium further hamper the primary closure of lateral (anterior) auricular skin defects. We present herein a case in which we used a helical rim advancement flap along with an additional postauricular skin flap. We achieved a satisfactory esthetic result with minimal loss of helical diameter and a low risk of flap necrosis by preserving the vascular network of the flap. This technique is less traumatic and will facilitate faster healing as well as improved patient recovery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.46.1-46.7
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• 2016

Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.655-662
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• 2011

Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

• Archives of Plastic Surgery
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• v.51 no.4
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• pp.432-440
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• 2024

Background The risk of flap necrosis in tissue reconstruction surgery is elevated in patients with vascular disorders, such as diabetes mellitus. Chronic hyperglycemia causes endothelial cell dysfunction and increases inflammatory process, causing vascular insufficiency. Platelet-rich plasma (PRP) contains high levels of platelets, growth factors, and fibrinogens. Its regenerative properties spark interest in supporting flap survival in relation to diabetic complications. Methods Thirty Wistar rats were divided into three groups. The first group included diabetic rats without PRP injection, which underwent flap procedure. The second group included diabetes-induced rats receiving PRP subcutaneous injection 1 day prior to flap procedure. The third group included nondiabetic rats receiving PRP injection 1 day prior to flap procedure. Flap tissue samples were taken on the seventh day to measure vascular endothelial growth factor (VEGF) levels using enzyme-linked immunosorbent assay method; angiogenesis and collagen density were measured from histopathology examination, and flap viability was analyzed using digital measurements. Results Analysis showed that flap viability, angiogenesis, and VEGF levels were significantly higher in the PRP-injected diabetic rats compared with diabetic rats that did not receive PRP. The levels of VEGF, angiogenesis, and viability of flaps in diabetic rats given PRP did not differ significantly compared with nondiabetic rats that received PRP. Conclusion Flap preconditioning through local injection of activated PRP enhances flap viability, VEGF levels and angiogenesis, in random skin flaps in diabetic rats, to the level where it does not differ significantly to nondiabetic rats that were given PRP.

• Korean Journal Plant Pathology
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• v.10 no.1
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• pp.64-67
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• 1994

Crown rot was found find tomatoes growing on a rockwool culture system in a glasshouse at Dongkwangyang in 1992. The disease occurred on the stem of 'Trust' tomato plants with 3~4 cluster of flowers. Infected plants showed stem girdling and necrosis at or slightly above the rockwool line. Internal tissues of crown and stem including cortex, vascular bundle, and pith became decayed resulting in a chocolate-brown discoloration extending no more than 10~15 cm above the crown. Diseased tomato plants with the similar symptoms were found at Ansung and Taejon where tomatoes were grown on either rockwool or soil in plastic greenhouses. The size of macroconidia of Fusarium isolated from a diseased plant was 26.0~41.6$\times$2.9~4.7${\mu}{\textrm}{m}$, and microconidia were formed on short monophialide and the size was 3.6~12.5$\times$2.9~3.6 ${\mu}{\textrm}{m}$. Morphological characteristics and inoculation tests indicated that the causal organism of the disease was Fusarium oxysporum.

• Food Science and Preservation
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• v.23 no.3
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• pp.378-386
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• 2016

Anti-atherogenic effects in tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$)-stimulated human umbilical vein endothelial cells (HUVEC) are involved in the suppression of oxidative stress, cell adhesion molecules, and pro-inflammatory factors. This study investigated the vascular inflammation inhibitory activity of traditional Doenjang plays a key role in the pathogenesis and progression of atherosclerosis. The protective effects of Korean Deonjang was investigated on the expression of cell adhesion molecules (CAMs) in tumor necrosis factor (TNF)-${\alpha}$-induced human umbilical vascular endothelial cells (HUVECs). Deonjang extracts (20, 50, $100{\mu}g/mL$) decreased the expression of 20 ng/mL TNF-${\alpha}$-induced vascular cell adhesion molecule (VCAM)-1 intracellular adhesion molecule (ICAM)-1 proteins, and their corresponding mRNA levels. Nitric oxides (NO) produced by endothlial nitric oxides synthase (eNOS) dilated blood vessels, which had protective effects against platelet and leukocyte adhesion. While TNF-${\alpha}$-induced suppressed the production of nitric oxide in HUVECs, Doenjang restored NO production in HUVECs. In addition, Deonjang reduced the TNF-${\alpha}$-induced expression of inducible NO synthase (iNOS) and cyclooxygenase (COX)-2 mRNA levels. These results suggested that Doenjang can inhibited the production of cell adhesion molecules and inflammatory mediators, which could be a potential candidate for preventing atherosclerosis.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.775-779
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• 1984

Reconstruction of the pharynx and cervical esophagus is a difficult surgical problem. A successful case of reconstruction of cervical esophagus by free jejunal graft upon a 23-year-old female who had stricture in the pharynx and cervical esophagus after ingestion of hydrochloric acid is presented. This procedure was done after the primary traditional reconstruction with right sided colon had resulted in restenosis due to necrosis of the cervical portion of the graft. A proximal jejunal segment, about 12 cm in length was isolated for free graft preserving its vascular arcade. Both superior thyroid artery and vein were anastomosed to the graft vessels in end to end by continuous suture of 8-0 monophil. Nylon. The postoperative course was uneventful. The patient has been followed for 4 months after operation and she can eat every kind of food without dysphagia. We think free jejunal graft offers an excellent and safe method of reconstructing cervical esophagus and pharynx with definitive advantages over other traditional techniques.