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Vulvar Reconstruction Using Keystone Flaps Based on the Perforators of Three Arteries

  • Yunjae Lee;Sanghun Lee;Dongkyu Lee;Hyeonjung Yeo;Hannara Park;Hyochun Park
    • Archives of Plastic Surgery
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    • 제49권6호
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    • pp.724-728
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    • 2022
  • Various flaps are used to reconstruct skin and soft tissue defects of the vulva following resection of malignancies. Whenever possible, reconstruction using local flaps is the standard treatment. Here, we describe vulvar defect reconstruction using keystone flaps. Standard keystone flaps are based on randomly located vascular perforators. However, we designed a keystone flap that includes perforators of three named arteries (the anterior labial artery of the external pudendal artery, cutaneous branches of the obturator artery, and posterior labial artery of the internal pudendal artery) and the pudendal nerve, which accompanies the internal pudendal artery. Four patients with squamous cell carcinoma and extramammary Paget's disease of the vulva underwent radical vulvectomy and keystone flaps including perforators of three arteries. Depending on the morphology of the defects, keystone flaps were used with different designs. For elliptical and unilateral vulvar defects, a standard keystone flap was designed, and for defects on both sides of the vulva, a double opposing keystone flap was used. For oval defects, the omega variant keystone flap was designed, and when the morphology of the defect needed rotation of the flap, a rotational keystone flap was designed. All the patients showed good function and sensation, with an acceptable cosmetic appearance.

고슴도치 췌장 내분비의 Glucagon(A),Insulin(B),Somatostatin(D)및 Pancreatic Polypeptide(PP) (Immunocytochemical Study on Endocrine Cells Containing Insulim, Glucagon, Somatostatin and Pancreatic PoIypeptide in the Pancreas and of the Hedgehog, Erinaceus koneanus)

  • 최월봉;최창도;원무호;서지은;김남중
    • 한국동물학회지
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    • 제31권2호
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    • pp.111-121
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    • 1988
  • 고슴도치의(Erinaceus koneanus)췌강 각 부위별에 출현하는 glucagon(A)세포,insulin(B)세포, somatostatin(D)세포 및 pancreatic polypeptide(PP)세포 등 4종의 내분비세포의 출현빈도, 분포상태, 모양 및 크기 등을 관찰하고자 췌장을 비장부와 십이지장부로 구분하고 이를 각각 근위부, 중간부 및 원위부로 세분한 후 면역세포화학적 방법을 시도하여 광학현미경하에서 검경하였던 바 다음과 같은 결론을 얻었다. Glucagon(A)세포의 크기는13 $\mu$ m x 9.5 $\mu$ m였고 그 모양은 원형, 난원형 및 추체형을 띠고 있었으며 췌도의 주변부와 외분비 실질사이에 분포하고 있었다. A세의 출현빈도는 비장부의 모든 부의에서 24.5%-30.5%, 십이지장부의 원위부에서 30.1%로 관찰되었으나 십이지장부의 근위부와 중간부에서는 2.6%-5.2%로 관찰되었다. Insulin(B)세포의 크기는 11.6$\mu$m x 9.4$\mu$m로서 원형 또는 난원형을 띠었고 췌도내에 균등하게 분포하고 있었으며, 비장부의 모든 부위와 십이지장의 원위부에서는 63.5%-68.9%, 십이지장부의 근위부와 중간부에서는 35.9%-55.6%로 출현하였다. Somatostatin(D)세포는 크기가 12.6$\mu$m x 9.1 $\mu$m로서 주변부와 외분비 실질사에 나타났으며 세포의 출현빈도는 비장부와 십이장부의 모든 부위에서 2.6%-5.9%로서 소수 관찰되었다. Pancreatic polypeptide(PP)세포는 크기가 12.8$\mu$ m x 8.5 $\mu$m였고 세포의 모양은 원형, 난원형 및 추체형 등 다양하였으며 췌도의 주변부와 외분비실질간에 주로 분포하고 있었다. PP세포의 출편빈도는 십이지장부의 근위부와 중간부에서는 각각 42.5%, 55.4%로서 관찰된 반면 비장부의 모든 부위와 십이지장부의 원위부에서는 0.5%-2%로서 소수 출현되었다.

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Molecular Characterization and Survey of the Infection Rate of Orchid fleck virus in Commercial Orchids

  • Kim, Sung-Ryul;Yoon, Ju-Yoon;Choi, Gug-Sun;Chang, Moo-Ung;Choi, Jang-Kyung;Chung, Bong-Nam
    • The Plant Pathology Journal
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    • 제26권2호
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    • pp.130-138
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    • 2010
  • Orchid fleck virus (OFV) is an unassigned plant virus in the family Rhabdoviridae. OFV was isolated from Cymbidium sp. showing oval necrotic lesions on their leaves in Korea, and designated as OFV-NHHS1. The complete nucleotide sequence of the RNA1 (6,413 nt) (GenBank accession no. AB516442) and RNA2 (6,001 nt) (GenBank accession no. AB516441) was determined in this study. RNA1 and RNA2 contained five and one ORF respectively. RNA1 encodes nucleocapsid (N) of 49 kDa, ORF2 of 26 kDa, ORF3 of 38 kDa, ORF4 of 20 kDa and glycoprotein (G) of 61 kDa proteins, whereas RNA2 encodes a single polymerase of 212 kDa. OFV-NHHS1 shared extremely high similarity of 98.6-100% and 98.9-99.6% in nucleotidle and amino acid sequences with a Japanese isolate, OFV-so, respectively. However, the N, G and L of OFV-NHHS1 revealed 6.9-19.3%, 7.3-12.0%, and 13.4-26.6% identities to those of 29 Rhabdoviruses, respectively. To survey the infection rate of OFV in commercial orchids in Korea, 51 Cymbidium sp., 10 Phalaenopsis sp., 22 Oncidium sp. and 21 Dendrobium sp. plants that showed typical viral symptoms were collected. RT-PCR with specific primers for detection of Cymbidium mosaic virus (CymMV), ORSV and OFV showed high infection rate by ORSV alone and double infection by ORSV and CymMV. One of the orchids tested was infected with OFV. This is the first report of the complete nucleotide sequences of OFV isolated in Korea.

한국재래산양 뇌하수체의 성장자극세포 및 젖샘자극세포에 관한 면역조직화학적 연구 (Immunohistochemical studies on somatotropes and mammotropes in hypophysis of Korean native goat)

  • 이인세;이흥식;강태천;서제훈;송승훈;남영삼
    • 대한수의학회지
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    • 제38권3호
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    • pp.497-507
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    • 1998
  • The localizations and morphological characteristics of immunoreactive cells for prolactin(PRL) and growth hormone(GH) antisera were studied with double immunohistochemistry in the adenohypophysis of the Korean native goat. PRL immunoreactive cells(mammotropes) and GH immunoreactive cells(somatotropes) were present in the pars distalis and pars tuberalis, but not in the pars intermedia. A few cells were stained with both PRL and GH antisera (somatomammotropes). The possessional percentages of mammotropes, somatotropes and somatomammotropes were 37.0%, 32.6%, 1.0% in females and 35.6%, 32.6%, 1.1% in males, respectively. Mammotropes were oval or round in shape, and $10{\sim}20{\mu}m{\times}17{\sim}25{\mu}m$ in size. These cells were distributed throughout the pars distalis, but were more abundant on the dorsal part adjacent to the hypophyseal cavity and along the lateral and ventral peripheral regions. Somatotropes were elliptical, triangular or polygonal in shape, and $8{\sim}17{\mu}m{\times}17{\sim}18{\mu}m$ in size. The distribution pattern of somatotropes was similar to that of mammotropes. Some somatomammotropes were intercalated between clusters of mammotropes while the others were dispersed independently among the secretory cells.

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참갈겨니 Zacco koreanus와 눈동자개 Pseudobagrus koreanus의 생태학적 차이에 의한 망막 조직의 비교 연구 (Comparative Study of the Retinal Structure in Two Korean Endemic Freshwater Fishes, Zacco koreanus (Cyprinidae) and Pseudobagrus koreanus (Bagridae) Based on Their Habitats)

  • 유민정;박종영
    • 한국어류학회지
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    • 제20권2호
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    • pp.97-104
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    • 2008
  • 한국산 고유 담수 어종인 참갈겨니와 눈동자개의 안구 외부형태와 망막구조를 광학현미경과 전자현미경으로 비교 조사하였다. 참갈겨니는 안구의 크기뿐만 아니라 수평안경/체장, 수평안경/두장의 비율이 모두 눈동자개보다 크게 나타났고 다만, 수정체직경/수평안경은 눈동자개가 더 크게 나타났다. 망막의 시각세포층에서 참갈겨니는 크게 단일원뿔세포와 이중원뿔세포, 두 종류의 원뿔세포를 가지며 단일원뿔세포는 긴단일원뿔세포와 짧은단일원뿔세포로 나뉜다. 반면 눈동자개는 긴단일원뿔세포와 짧은단일원뿔세포로 구분할 수 없는 단지 단일원뿔세포로만 구성되어 있었다. 또한 원뿔세포의 배열구조에 있어서도 참갈겨니는 보다 치밀한 열구조로 배열되어 있는 반면 눈동자개는 성긴 불규칙한 구조로 배열되어 있었다. 이상과 같이 참갈겨니와 눈동자개의 안구 및 망막의 구조적 차이는 2종 간의 생태학적 특성과 밀접한 관련이 있는 것으로 생각된다.

Recombinant human granulocyte macrophage colony-stimulating factor (rhGM-CSF) could accelerate burn wound healing in hamster skin

  • Heo, Si-Hyun;Han, Kyu-Boem;Lee, Young-Jun;Kim, Ji-Hyun;Yoon, Kwang-Ho;Han, Man-Deuk;Shin, Kil-Sang;Kim, Wan-Jong
    • Animal cells and systems
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    • 제16권3호
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    • pp.207-214
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    • 2012
  • Burns are one of the most devastating forms of trauma and wound healing is a complex and multicellular process, which is executed and regulated by signaling networks involving numerous growth factors, cytokines, and chemokines. Recombinant human granulocyte macrophage colony-stimulating factor (rhGM-CSF) was specifically produced from rice cell culture through use of a recombinant technique in our laboratory. The effect of rhGM-CSF on promotion of deep second-degree burn wound healing on the back skin of a hamster model was evaluated through a randomized and double-blind trial. As macroscopic results, hamster skins of the experimental groups showed earlier recovery by new epidermis than the control groups. Immunohistochemical reactions of proliferating cell nuclear antigen and transforming growth factor-b1, which are indicators of cell proliferation, were more active in the experimental group, compared with the control group. On electron microscopy, basal cells in the epidermis of the experimental group showed oval nuclei, prominent nucleoli, numerous mitochondria and abundant free ribosomes. In addition, fibroblasts contained well-developed rough endoplasmic reticulum with dilated cisternae. Bundles of collagen fibrils filled the extracellular spaces. Particularly, ultrastructural features indicating active metabolism for regeneration of injured skin at 15 days after burn injury, including abundant euchromatin, plentiful free ribosomes, and numerous mitochondria, were observed. These findings suggest that use of rhGM-CSF could result in accelerated deep second-degree burn wound healing in animal models.

Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck

  • Park, Hyochun;Lee, Yunjae;Yeo, Hyeonjung;Park, Hannara
    • 대한두개안면성형외과학회지
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    • 제22권4호
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    • pp.183-192
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    • 2021
  • Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.

해산어류 명태(Theragra chalcogramma)에 기생하는 조충류 조사 (A Study on the Cestodes in yheyagya chalcogramma)

  • 주종필
    • Parasites, Hosts and Diseases
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    • 제22권1호
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    • pp.85-95
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    • 1984
  • 한국 시장에서 얻은 명태의 장내 기생 조충류 조사의 일환으로 이 연구를 실시하였다. 명태의 장에서 얻은 각종 충체에 대하여 형태학적 계측과 박절표본을 작성한 소견을 가지고 Schmidt와 Yamaguti의 검색표에 의거하여 속과 종을 동정한 바 다음과 같은 결과를 얻었다. 1. 본 실험에서 국내에 미기록된 신종으로 Eucestoda 아강 Caryophyllidae목 Caryophyllaeidae과 Lytocesinae아과 Khawa속과 Eucestoda아강 Trypanorhyncha목 Acystidea아목 Paranybeliniidae과 Pseudonybelinia속과, Eucestoda아강 Trypanorhyncha목 Aeystidea아목 Tentaculariidae과 Nybelinia속과 Tentacularia속 그리고 Eucestoda아강 Trypanorhyncha목 Cystidae아목 Lacistorhynchidae과 Eulacistorhynchus속과 이들의 종을 확정하였다. 2. Khawia sinesis의 특징은 두절에 소포가 없으며 넓고 펑평하나 가장자리가 들쑥날쑥한 점과 목이 짧고 체부와 두부사이가 명화하지 않은 점이었다. 3. Eulncistorhynchus chiloscyllius의 특징은 두절이 꽤 긴 편이며 가장자리가 들쑥날쑥하지 않다. 구문낭도 길다. 수축근은 남의 기저부에 부착되어 있다. 흡구는 둘로 난형 혹은 원형이며 후단에, 절흔이 없다. 촉모는 길 갈고리들이 변형되어 있으며 이중의 chainette가 있다. 체절은 acraspedote하고 성숙체질은 체폭보다 길이가 더 길다. 4. Tentacularia coryphaenea의 특징은 두절이 들쑥 날쑥하지 않고 원주형이다. 흡구는 분리되었고 후단 유리 연에는 작은 가시가 있다. 두절에서 나온 4개의 수축성 촉모에는 갈고리들이 나선형으로 배열되어 있다. 촉모를 둘러싼 초는 꼬여있지 않다. 근낭은 긴 타원형이다. 5. Pseudonybelinia odontacantha의 특징은 두절이 들쑥날쑥하지 않고 촉모는 계구의 전쳔부에 가까이 부착되어 있다. 갈고리는 좌측으로 부터 나선상으로 배열되어 있다. 근낭은 폭보다 길이가 3배정도 긴다. 6. Nykelinia lingu구곤의 특징은 두절이 짧고 들쑥 날쑥하지 않다 흡구는 4개로 분리되어 있으며 각기 자유판을 갖고 있다. 촉모는 원통상으로 단단한 갈고리로 무장되어 있다.

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선천성 심실중격결손증 교정술 후 발생한 가성 상행대동맥류 수술 치험 -1례 보고- (Surgical Treatment of the Pseudoaneurysm of the Ascending Aorta Following the Repair of Congenital VSD -1 case report-)

  • 안병희;김광휴;나국주;김상형
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.564-568
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    • 1996
  • 개심술후 발생하는 가성 상행대동맥류의 빈도는 매우 낮으나 점진적으로 진행하여 크기가 커지면 커 질수록 수술사망률이 높기 때문에 정기적인 검진으로 조기에 발견하여 주위 조직을 압박 변위시키기 전 에 외과적으로 교정하는 것이 바람직하다. 본 교실에서는 선천성 심실중격결손증 교정술 후 50개월이 경과하여 발견된 가성 상행대동맥류 1례 를 성공적으로 치료하였기 에 문헌고찰과 합께 보고하는 바이다. 환아는 14세 여아로9세때 선천성 심실중격결손증으로타병원에서 팻취봉합술에 의한근치술을받고 합병증으로 창상감염이 발생하였으나 완치된 후 정상적인 생활을 하여오다 1 개월전에 발생한 운동성 호흡곤란과 전신피로감을 주소로 내원하여 검진중 가성 상행대동맥류로 진단되어 상행대동맥성형술을 받았다. 수술소견상 대동맥 및 심정 지액 관류를 위 해 삽관하였던 부위로 추정되는 상행대동맥에 각각 장 경 1.5cm정도의 개구부가 있었으며 가성대동맥류의 크기는 10$\times$7cm로 주폐동맥, 상대정맥, 우심방, 우심실 등을 심하게 변위시키고 있었다. 2개의 개구부 사이에 위치한 대동맥 벽을 제거하여 하나의 개구부 로 만든 후 Dacron graft를 재단\ulcorner여 만든 팻취를 이용하여 대동맥성형술을 시행하였다. 수술합병증은발생하지 않았으며 술후 12일째에 건강하게 퇴원하였다.

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설비공학 분야의 최근 연구 동향 : 2013년 학회지 논문에 대한 종합적 고찰 (Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2013)

  • 이대영;김사량;김현정;김동선;박준석;임병찬
    • 설비공학논문집
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    • 제26권12호
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    • pp.605-619
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    • 2014
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2013. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of fluid machinery, pipes and relative parts including orifices, dampers and ducts, fuel cells and power plants, cooling and air-conditioning, heat and mass transfer, two phase flow, and the flow around buildings and structures. Research issues dealing with home appliances, flows around buildings, nuclear power plant, and manufacturing processes are newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for general analytical model for desiccant wheels, the effects of water absorption on the thermal conductivity of insulation materials, thermal properties of Octadecane/xGnP shape-stabilized phase change materials and $CO_2$ and $CO_2$-Hydrate mixture, effect of ground source heat pump system, the heat flux meter location for the performance test of a refrigerator vacuum insulation panel, a parallel flow evaporator for a heat pump dryer, the condensation risk assessment of vacuum multi-layer glass and triple glass, optimization of a forced convection type PCM refrigeration module, surface temperature sensor using fluorescent nanoporous thin film. In the area of pool boiling and condensing heat transfer, researches on ammonia inside horizontal smooth small tube, R1234yf on various enhanced surfaces, HFC32/HFC152a on a plain surface, spray cooling up to critical heat flux on a low-fin enhanced surface were actively carried out. In the area of industrial heat exchangers, researches on a fin tube type adsorber, the mass-transfer kinetics of a fin-tube-type adsorption bed, fin-and-tube heat exchangers having sine wave fins and oval tubes, louvered fin heat exchanger were performed. (3) In the field of refrigeration, studies are categorized into three groups namely refrigeration cycle, refrigerant and modeling and control. In the category of refrigeration cycle, studies were focused on the enhancement or optimization of experimental or commercial systems including a R410a VRF(Various Refrigerant Flow) heat pump, a R134a 2-stage screw heat pump and a R134a double-heat source automotive air-conditioner system. In the category of refrigerant, studies were carried out for the application of alternative refrigerants or refrigeration technologies including $CO_2$ water heaters, a R1234yf automotive air-conditioner, a R436b water cooler and a thermoelectric refrigerator. In the category of modeling and control, theoretical and experimental studies were carried out to predict the performance of various thermal and control systems including the long-term energy analysis of a geo-thermal heat pump system coupled to cast-in-place energy piles, the dynamic simulation of a water heater-coupled hybrid heat pump and the numerical simulation of an integral optimum regulating controller for a system heat pump. (4) In building mechanical system research fields, twenty one studies were conducted to achieve effective design of the mechanical systems, and also to maximize the energy efficiency of buildings. The topics of the studies included heating and cooling, HVAC system, ventilation, and renewable energies in the buildings. Proposed designs, performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment is mostly focused on indoor environment and building energy. The main researches of indoor environment are related to infiltration, ventilation, leak flow and airtightness performance in residential building. The subjects of building energy are worked on energy saving, operation method and optimum operation of building energy systems. The remained studies are related to the special facility such as cleanroom, internet data center and biosafety laboratory. water supply and drain system, defining standard input variables of BIM (Building Information Modeling) for facility management system, estimating capability and providing operation guidelines of subway station as shelter for refuge and evaluation of pollutant emissions from furniture-like products.