• Journal of Trauma and Injury
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• v.36 no.4
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• pp.404-410
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• 2023

Large scalp defects resulting from high-voltage electrical burns require free flaps, preferably skin, to permit optimal coverage and enable future or simultaneous cranial vault reconstruction. The anterolateral thigh permits the harvest of a large area of skin supplied by a reliable perforator. The superficial temporal vessels offer the proximate choice of recipient vessels to enable adequate reach and coverage. The lack of a second vein at this site implies the inability to perform a second venous anastomosis; however, this obstacle can be overcome by using an interposition vein graft, to the neck veins primarily. This assures adequate venous drainage and complete flap survival.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.57-62
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• 2005

Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.226-230
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• 1989

As carotid-cavernous fistula is the major complication that can be occurred uncommonly after maxillofacial injuries, it is abnormal arteriovenous communication between cavernous sinus and internal carotid artery. Such an arteriovenous communication is most often the result of injuries, but need not be associated with bony fracture. It usually begins soon after an injury, but it may be delayed for as long as several months. It begins undramatically with eye pain, headache and slow protrusion of eye ball. A bruit may be heard above the eye with stethoscope. Close examination will reveal dilatation of superficial veins of the eyelid and forehead and periorbital edema. There will be complete or partial ophthalmoplesia of the affected eye. Compression of the common carotid artery on the ipsilateral side will reduce or obliterate the bruit. The lesion in the cavernous sinus is them demonstrable by angiography.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.41-45
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• 2009

Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.611-614
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• 2001

To determine the efficacy and safety of endoscopic resection and ablation of superficial varicosities using a powered vein resector, irrigated illuminator. Material and Method: 83 consecutive patients were involved in the study. 103 limbs in 83 patients were treated using a minimal invasive, powered, vein resecting devide with cutaneous transillumination and tumescent anesthesia technique. There were 51 women and 32 men. All patients were operated under general anesthesia or regional anesthesia. Operative time and patient satisfaction scores were recorded along with the number of incisions made. Result: 83 patients(51/61.4% female, 32/38.6% male, aged 25-78 years) had varicose vein. Average age at the time of operation was 45 years(range, 25 to 78 years). There were 63 unilateral procedures and 20 bilateral operations. Operative time ranged from 24 to 46 minutes (average 35.3 minutes) in the unilateral procedure. The number of incisions per limb averaged 2.7(range, 2 to 5). Postoperative complications occurred in 7(8.4%) patients. Patients were asked to describe their pain on an analog scale ranging form 1 to 10 with r representing no pain and 10 worst imaginable pain. Immediately postoperative pain score was 2.4 Postoperative pain score at 72 hours had a mean score of 2.0. Postoperative pain score at 1 months were 1. Conclusion: Varicose vein removal using Transilluminated Powered Phlebectomy(TIPP) is a safe and efficient procedure. The procedure saves time, is easy to perform, and gives direct visualization and a distinct endpoint of the removal of veins. It is also less tedious to perform and gives good cosmetic results with significant pain relief.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.53-62
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• 2002

Several investigators have reported clinical experience of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of the hand and digits. Jayme and Hamilton first described the anatomy of superficial branch of medial division of the medial plantar artery used in this flap through cadavaric study in 1997. But, they had a few cases for this flap and there was no anatomic study in Korean. We experienced the reliability of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of hand and digits through an anatomic study (20 fresh specimens dissected) and clinical application (17 patients). An anatomic study revealed that there were differences in diameter and length of the vessels between Korean and Caucasian. The diameter of vessels in Korean is larger than Caucasian one in each area. Based on this anatomic knowledge, we could harvest this flap safely, and have performed reconstruction on 17 patients with soft tissue defects of hand and digits using a thin, flexible medial plantar septo-cutaneous flap similar to the volar aspect of the hand and digits in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitants, or the subcutaneous veins. The mean size of the flap was $2.82cm{\times}4.15cm$. All the flaps survived without significant complications. A medial plantar septo-cutaneous flap possesses several advantages : (1) It is very thin in comparison with other standard free flap; (2) it has two draining venous pathways; (3) it provides a good color and texture match for hand and finger; (4) a good recovery of protective sensation is achievable.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.439-442
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• 1999

An animal health monitoring system in Gyeongnam area (near-Chinju) was studied to evaluate the environmental risk factors, physical examinations and 4 disease entities(abomasal displacement, traumatic reticulopericarditis ＆ -peritonitis, milk fever and lameness) in 40(34 in second year)dairy herds (total 1253 dairy cattle). In feeding environments, we examined housing system, forage percentage in ration, stall types, playground, cleanness of stall. In housing system, most of herds (60%) have tie-stall types and 36 herds are open-type housing. The forage ratio of ration was less than 50% in most of herds (67%). 39 herds had their own playgrounds and the frequency of playground cleanness was irregular, Physical examinations included the T(temperature), P (pulse), R (respiration), abnormalities of superficial lymph nodes, claw examination and total CBC with blood from tail veins. T, P, R are within normal limits (T : 38.1$\pm$0.6$^{\circ}C$, P : 84.6$\pm$12.9/min., R : 24.0$\pm$7.6/min. ,respectively), the swelling of lymph nodes were shown in 13 cattle and overall claw trimming was required in 3 herds. In blood examination, 23 cattle showed leuko-cytosis and 7 cattle showed low RBC and hemoglobin level, the other cattle were within normal limits (WBC : 8.90$\pm$2.06 10$^3$/ul., RBC : 6.36$\pm$1.02 10$^{6}$ ul, Hb : 9.83$\pm$ 1.20 g/dl PCV : 27.43$\pm$5.67 %, respectively). In 4 disease entities, we found some metallic foreign bodies in men of 13 cattle, which had predisposing factors of traumatic reticulopericarditis and reticuloperitonitis, 13 abomasal displacement, 51 milk fever and lameness in 39 cattle.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.316-319
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• 2010

An aneurysm is a focal, localized dilatation of a blood vessel. This term is most commonly applied to dilatation of arteries. However, dilatation can occur in any part of the vascular system. Primary true aneurysm of the superficial venous system that contains all the vascular layers is known to be very rare. We report here on surgically treating a case of primary true aneurysm on the dorsalis pedis vein and we briefly review the related literature.

• Asian-Australasian Journal of Animal Sciences
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• v.33 no.11
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• pp.1770-1778
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• 2020

Objective: This study was conducted to reveal potential metabolic differences of dairy cows fed corn stover (CS) and rice straw (RS) instead of alfalfa hay (AH) as main forage source. Methods: Thirty multiparous mid-late lactation Holstein dairy cows were selected and randomly assigned to three diets, AH, CS, or RS (n = 10). After 13 weeks of the feeding trial, coccygeal arterial and superficial epigastric venous plasma samples were collected before morning feeding for gas chromatography time-of-flight/mass spectrometry analyses. Results: In the artery, 8 and 13 metabolites were detected as differential metabolites between AH and CS, and between AH and RS, respectively. The relative abundance of phenylpropanoate (log₂fold change [FC]) = 1.30, 1.09), panthenol (log₂FC = 2.36, 2.20), threitol (log₂FC = 1.00, 1.07), and 3,7,12-trihydroxycoprostane (log₂FC = 0.79, 0.78) were greater in both CS and RS than in AH, and tyrosine (log₂FC = -0.32), phenylalanine (log₂FC = -0.30), and pyruvic acid (log₂FC = -0.30) were lower in RS than in AH. In the vein, 1 and 7 metabolites were detected as differential metabolites between AH and CS, and between AH and RS, respectively. By comparing AH and RS, we found that metabolic pathways of phenylalanine, tyrosine, and tryptophan biosynthesis and phenylalanine metabolism were enriched by integrative artery and vein analysis. Furthermore, AH and RS, arterial phenylpropanoate and 4-hydroxyproline were positively, and phenylalanine was negatively correlated with milk urea nitrogen. Finally, in AH and CS, arterial panthenol was negatively correlated with feed efficiency. Conclusion: Arterial metabolic profiles changed more than those in the veins from animals on three forage diets, differing in amino acids. We found that phenylalanine, tyrosine, and tryptophan biosynthesis and phenylalanine metabolism were restricted when cows were fed low-quality cereal straw diets.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.741-745
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• 2015

Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.