• Archives of Plastic Surgery
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• v.34 no.5
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• pp.587-592
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• 2007

Purpose: In case of postburn flexion contracture of the fingers, skin graft, geometrical relaxation techniques, local flap, and free flap have been used. Among these procedures, full-thickness skin grafts from the inguinal area are widely used to reconstruct a postburn flexion contracture in the fingers. But there are many esthetic and functional problems in this procedure. Especially, hyperpigmentation of the skin-grafted fingers poses a troublesome problem, particularly in the patients who have dark colored skin. To solve the problem, we have used pulp graft which was harvested from the lateral aspect of great toe. In the present study, we report pulp graft, with which we have obtained a good result in the treatment of postburn flexion contracture of the fingers. Methods: Between September of 2004 and August of 2006, great toe pulp graft was performed to 20 sites of 15 patients. After release of the postburn flexion contracture using Z-plasty, the composite tissue (pulp) harvested from the lateral aspect of great toe was grafted on the raw surface. Moisture dressing with ointment and foam dressing material was performed. Stratum corneum of the graft got stripped off in two to four weeks after pulp graft. The color of the pulp graft was slightly reddish, then it became similar to the adjacent tissue. Results: There was complete take in all the patients who were treated with pulp graft. Great toe pulp graft provided similar color and texture to the adjacent skin, high rate of graft take, and left only a minimal scar at donor site. Conclusion: Thick keratin layer and inelastic nature of the pulp make this type of the graft much easier and simpler, and ensure a better take. Pulp graft is useful method for the reconstruction of the postburn flexion contracture in fingers.

• Archives of Plastic Surgery
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• v.41 no.2
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• pp.133-139
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• 2014

Background Various shapes and designs of the gluteal artery perforator flap have been used for treating sacral pressure sores and reconstructing breasts. To establish the ideal fasciocutaneous flap design for use in the gluteal area, the soft tissue thickness distribution was measured. Methods Twenty-one buttocks of adult Korean cadavers were analyzed through rectangular subfascial dissection. Each buttock was divided horizontally into 10 sections and vertically into 10 sections, and then, the thickness at the corners of the sections was measured. For the sake of comparison and statistical verification with living bodies, computed tomography (CT) images of 120 buttocks of patients were randomly selected. Five horizontal sections and 4 vertical sections were made, and the thickness at each corner was recorded. Results According to the dissection and the CT images, the area with the thinnest soft tissues in the buttock was around the posterior superior iliac spine, close to the sacral area. The thickest area was the superolateral area of the buttock, which was 3.24 times and 2.15 times thicker than the thinnest area in the studies on cadaver anatomy and the CT images, respectively. Conclusions The thickness of the soft tissues in the buttocks differed by area. The superolateral area had the thickest soft tissues, and the superomedial area had the thinnest. This study includes information on the distribution of the thickness of the gluteal soft tissues of Koreans. The outcome of this study may contribute to the design of effective local flaps for pressure sore reconstruction and free flaps for breast reconstruction.

• Radiation Oncology Journal
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• v.1 no.1
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• pp.47-53
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• 1983

CT scans obtained on 15 patients of head and neck malignant tumors were evaluated for their utility in ratiotherapy treatment planning. To evaluate the advantage of incorporating CT scans in radiotherapy treatment planning of head and neck malignant tumors, the dose distributions of treatment plan with and without CT scan were compared in 15 patients. And then the dose distributions of the first and second treatment plan were compared. 1. Tumor extend and localization were clearly delineated on CT scan in 12 of 15 cases (80%), suggestive in 2 (13.3%), and not seen in only one (6.7%) which had been in the postoperative state. 2. Tumor coverage after CT scan was adequate in 14 of 15 cases (93.3%) and not in only one. In one case of inadequate tumor coverage the target volume lay inside the field but reached within 0.5cm of the field margin (marginal miss). 3. The volume of normal tissue irradiated was reduced after CT scan in 12 of 15 cases (80%), increased in 1 (6.7%) and not changed in 2 (13.3%). 4. We could maximize the local control of disease and minimize unnecessary morbidity by delineating the location and extent of tumor and normal tissue with CT for treatment plannings.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.6
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• pp.771-778
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• 1998

To investigate interaction of angiotensin converting enzyme (ACE) inhibitor with local tissue renin- angiotensin system (RAS), changes in gene expression of the RAS components in various tissues in response to chronic administration of an ACE inhibitor, enalapril, were examined in Sprague-Dawley male rats. Enalapril was administered in their drinking water $(3{\sim}4\;mg/day)$ over 8 wk. Plasma and renal ACE activity increased significantly after 4 and 8 wk of enalapril treatment. Renin levels of the plasma and kidney of the enalapril-treated rats markedly increased after 4 wk and decreased thereafter, but still remained significantly higher than those of control rats. Kidney mRNA levels of renin markedly increased after 4 and 8 wk of enalapril treatment, but those of angiotensinogen and ANG II-receptor subtypes, $AT_{1A}$ and $AT_{1B}$, did not change significantly. The liver expressed genes for renin, angiotensinogen and $AT_{1A}$ receptor subtype, but $AT_{1B}$ receptor subtype mRNA was not detectable by RT-PCR. None of mRNA for these RAS components in the liver changed significantly by enalapril treatment. The hypothalamus showed mRNA expressions of renin, angiotensinogen, $AT_{1A}$ and $AT_{1B}$ receptor subtypes. $AT_{1A}$ receptor subtype mRNA was more abundant than $AT_{1B}$ receptor subtype in the hypothalamus as shown in the kidney. However, gene expression of the RAS components remained unchanged during 8-wk treatment of enalapril. In the present study, chronic ACE inhibition increased plasma and renal levels of ACE and renin, but did not affect mRNA levels of other RAS components such as angiotensinogen, ANG II receptor subtypes in the kidney. Gene levels of the RAS components in the liver and hypothalamus were not altered by chronic treatment of enalapril. These results suggest the differential expression of the RAS components in response to enalapril, and localized action and some degree of tissue specificity of enalapril.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• International Journal of Oral Biology
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• v.37 no.1
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• pp.25-29
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• 2012

During maxillofacial surgery, the infraorbital and mental nerves are blocked at eac foramen to induce local anesthesia. This study examined the relative locations of the infraorbital foramen (IOF) and mental foramen (MF) based on softtissue landmarks. Twenty-eight hemifacial cadavers were dissected to expose the IOF and MF. The distances between the bilateral IOFs, the bilateral MFs, the alae of the nose (alares), and the corners of the mouth (cheilions) were measured directly on cadavers by using a digital vernier caliper. The vertical and horizontal distances of the IOF and MF relative to the alare and cheilion were measured indirectly on digital photographs using Adobe Photoshop (Adobe, CA, USA). The distance between the bilateral IOFs ($58.09{\pm}4.04mm$) was longer than the distance between the bilateral MFs ($50.32{\pm}1.93mm$). The distances between the bilateral alares and cheilions were $41.22{\pm}3.44mm$ and $58.43{\pm}6.62mm$, respectively. The IOF was located $12.92{\pm}3.75mm$ superior and $7.88{\pm}2.56mm$ lateral to the alare, and the vertical angle (Angle 1) between these structures was $31.67{\pm}13.36^{\circ}$ superolaterally. The MF was located $21.83{\pm}3.26mm$ inferior and $5.56{\pm}3.37mm$ medial to the cheilion, and the vertical angle (Angle 2) between these structures was $14.05{\pm}10.12^{\circ}$ inferomedially. In conclusion, these results provide more detailed information about the locations of the IOF and MF relative to soft-tissue landmarks.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.573-584
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• 2003

Bone remodeling results from the combined process of bone resorption and new bone formation which is regulated in part by some of Dexamethasone related proliferation & mineralization of cultured bone cell and polypeptide growth factors such as platelet derived growth factor(PDGF), which has been known to be an important local regulator of bone cell activity and participate in normal bone remodeling. To evaluate the effects of Dex and PDGF on bony healing of calvarial defect in rats, 10 ng/ml PDGF were applied on P group and 10 ng/ml PDGF and $10^7$ M Dex were applied PD group. 4 rats in each group were sacrificed at 7, 14. 21 days after operation respectively, and the tissue blocks were prepared for light microscope with H-E for evaluation of overall healing, with TRAP(tartrate resistant acid phosphatase) for evaluation of osteoclastic activity and with immunohistochemical staining for macrophages. The results were as follows : 1. In all group, healing aspects were progressed from 7 days to 21 days in soft and bony tissue, but complete repair were not observed in bony defect 2. PDGF and control group were showed similar bony healing aspect , but bony healing in combination of PDGF-BB and Dex were observed slower aspect compared to PDGF and control group from early healing times. 3. There were no significant difference on activities of osteoclast and macrophages in bony healing between control and experimental group In conclusion, PDGF were not influenced on bony healing of defect and combination of PDGF-BB and Dex were showed slower healing through early healing times. it was considered that Dex compared to PDGF did influenced on early hone formation factors in healing period

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.671-678
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• 2007

Purpose: Venous malformation(VM) which often causes pain and discomfort is the most common type of vascular malformations. Although it is presented with disfigured appearance and associated soft tissue or skeletal hypertrophy, the molecular bases of VMs are poorly understood. Differentially expressed genes(DEGs) of VMs were investigated to illuminate the molecular mechanism of the disease entity. Methods: Gene expressions of VM patients' subcutaneous tissue were studied in comparison with normal persons' by $GeneFishing^{TM}$ technique using the annealing control primers (ACPs) to identify DEGs. Candidate genes were sequenced and screened by basic local alignment search tool (BLAST) afterwards. Results: Among seventy DEGs identified, forty DEGs which had shown significantly different expression pattern were sequenced. Twenty eight out of 40 were up-regulated while 12 were down-regulated. BLAST searches revealed that 37 were known genes and 3 were unknown genes. Many genes were involved in the differentiation and remodeling of smooth muscle cells, opposed to the previous hypothesis that a lot of angiogenetic genes would be involved. Furthermore, several transcription factors and related genes, as well as cell signaling and metabolism regulators, were up regulated. Conclusion: It suggests that analysis of DEGs in VMs provide basic knowledge about its pathophysiology. and new therapeutic approaches.

• Restorative Dentistry and Endodontics
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• v.9 no.1
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• pp.15-24
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• 1983

Irradiation is frequently employed as the sole therapy for oral cancer. These irradiated patients presents peculiar and progressive dental problems. But there is only scanty informations concerning specific approaches to endodontic treatment for head and neck cancer patients who have been subjected to tumorcidal doses of radiation therapy. The purpose of the present study was to determine the effects of cobalt-60 radiation on the pulpal healing of dogs after the direct pulp capping. As the experimental animals, 10 dogs (above 7-8 months after birth) were divided into 3 groups (Control, Group I, Group II). The cobalt-60 was irradiated to the Group I and Group II each 1,009 and 1,562.5 rads as single dose. As the capping material Dycal$^{(R)}$(L.D. Caulk company) was selected. After the direct pulp capping the dogs were sacrified 1, 2, 3, 4, week interval and made the original slides cut with a thickness of 8 microns and stained with hematoxylin and eosin. After examination and comparision of all specimen, the results of this study were drawn as follows; 1. The formation of reparative dentin was observed from the 1st week in the Control group, the 2nd week in the Group I & II. The few and irregular tuble structure was appeared in the 4th week in the Control group only, but failed in the Group I & II. 2. The continuity of dentin bridge was appeared in the 3rd week in all group and the degeneration of odontoblast in the 1st week of the Group II. 3. The congestion and hemorrhage in the pulp tissue were observed in all groups until 3rd week. The inflammation was appeared within the 2nd week in the Group I and especially marked in the Group II, but absent in the Control group. 4. In cases Dycal into the pulp tissue deeply, the local necrosis of pulp and decrease of dentin formation was observed.

• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.48-51
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• 2007

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.