• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.713-718
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• 2023

Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.

• Clinical Nutrition Research
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• v.13 no.3
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• pp.165-175
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• 2024

This study aimed to assess the relationship between serum levels of vitamin D with anthropometric indices, lipid profile and vascular inflammatory factors, in patients who candidate for coronary artery bypass grafting (CABG). This analytical cross-sectional study was conducted in patients who were candidate for CABG. Demographic information, medical records, anthropometric indicators, blood samples, and physical activity of 150 patients were collected. 146 participants with mean ± standard deviation of age: 61.8 ± 10.0 years and body mass index: 26.9 ± 3.7 kg/m² completed the study. Based on serum levels of vitamin D, patients were divided into 2 groups; groups with sufficient (≥ 30 ng/mL) and insufficient amount of vitamin D (< 30 ng/mL). The 30.14% of the patients had serum vitamin D deficiency. Ejection fraction (EF) % between the 2 groups had significant difference. Unexpectedly the EF% increased 7% in patients with insufficient level of vitamin D (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.11; p = 0.001). Vitamin D status had a significant inverse association with body weight. The odds of vitamin D deficiency significantly increased by 4% with increasing one kg in weight (OR, 1.04; 95% CI, 1-1.08; p = 0.044). There were no significant association between serum vitamin D level and intra cellular adhesion molecule-1, interleukin-17, fasting blood glucose, and lipid profile (p > 0.05). Considering the inverse association observed between serum vitamin D with EF% and body weight, vitamin D may play a role in modulating of these indices.

• Journal of Bio-Environment Control
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• v.25 no.4
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• pp.351-358
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• 2016

This study investigated the effect of different relative humidity (RH) regimes on graft healing of grafted seedlings of watermelon (Citrullus vulgaris Schrad.). Two watermelon cultivars ('Speed' and 'Sambok Honey') were grafted onto the 'RS-Dongjanggun' bottle gourd rootstock (Lagenaria siceraria Stanld.) and the grafted seedlings were maintained under one of three relative humidity regimes, 95-96% [1.1-0.8 (day) or $0.8-0.6(night)\;g{\cdot}m^{-3}$ vapor pressure deficit (VPD)], 97-98% [ 0.7-0.4 (day) or $0.5-0.3(night)\;g{\cdot}m^{-3}$ (VPD)], or 99-100% [0.3-0.0 (day) or $0.2-0.0(night)\;g{\cdot}m^{-3}$ (VPD)] according to the Mollier diagram based on the air temperature of $25^{\circ}C\;day/18^{\circ}C\;night$ with 16 h photoperiod per day. Among the RH treatments, 97-98% significantly increased plant height and fresh weight of the rootstock and scion of the 'Speed' and it also enhanced the graft union connection of both cultivars after two days of grafting. However, plant height and thickness of the scion of 'Sambok Honey' was increased by the 99-100% RH treatment. Furthermore, both cultivars grown in the 95-96 and 97-98% RH treatments consisted of lower levels of endogenous $H_2O_2$ and less activities of antioxidant enzymes which illustrated the occurrence of less oxidative stress. Hence, the results of this study identified the optimal RH level for the graft healing of watermelon seedlings.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.129-136
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• 2010

Purpose: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. Methods: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. Results: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap (18), medial plantar island flap (6), rotation flap (5), sural island flap (3), anterolateral thigh free flap (2), lattisimus dorsi muscular flap (2), and contra lateral medial plantar free flap (1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. Conclusion : Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor / recipient site (scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.35-45
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• 1996

After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.377-381
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• 2005

Background: Extra-anatomic bypass was performed in the patient who could not use anatomic bypass due to many causes. The purpose of this study is to evaluate the efficacy of extra-anatomic bypass surgery. Material and Method: We reviewed 31 patients who underwent extra-anatomic bypass surgery at Pusan national university hospital. We analysed the combined diseases, etiologic diseases, symptoms, patency rate and the factors affecting patency rate retrospectively. Result: There were 26 cases of femoro-femoral bypass and 5 cases of axillo-bifemoral bypass among 31 patients. The mean age was 70.23 years. Combined disease were hypertension, hyperlipidemia, and ischemic heart disease in order of frequency. The indications for surgery were disabled claudication, tissue necrosis, rest pain, and a cute ischemia. We analysed the ages, smoking history, hypertension, ischemic heart disease, severity of limb ischemia, and hyperlipidemia as factors affecting patency rate. We could not find any statistical differences between these factors. The primary graft patency rates were $73.65\%$ one year, $73.65\%$ two year, and $65.46\%$ three year respectively according to the Kaplan-Meier method. Conclusion: Nevertheless extra-anatomic bypass has a relatively low patency rate, it has good merits that is less dangerous, simple and easy re-do surgery compared to anatomic bypass. We think that extra-anatomic bypass is one of the good treatment modalities for the high risk vascular patients.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.582-586
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• 2007

A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.637-640
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• 2009

A 13-year-old female 30 kg Korean Jin-do dog was presented with severe defects due to vasculitis and perivascular dermatitis at the left antebrachium area. A left superficial brachial axial pattern flap was elevated to cover the defect and the wound was covered. However, one week post surgery, the flap was survived about 1/3 of total flap length. Remaining two thirds defects were performed by the free skin mesh graft as an additional method. After ten days, the entire wound was achieved completely. Skin flaps carry own blood supply in other hands, the flap method is dependent upon continuation of adequate circulation until vascularization takes place. Because they are much thicker than other grafts, this is a slower process and the flap method is vulnerable to problems with kinking or tension of the base. According to this case, a practician has to consider length of flap and thickness in order to vascular perfusion when superficial brachial axial pattern flap is performed in a dog.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.340-345
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• 2010

Purpose: Recently, bioceramics have become popular as a substitute graft material for reconstruction of bony defect after trauma or tumor surgery. Among the bioceramic materials, hydroxyapatite (HA) is favored due to its biocompatibility. HA scaffold is composed of the interconnected reticular framework, macropores and micropores. Macropores play an important role in cell migration, nutrients supply and vascular ingrowth. On the other hand, a number of micropores less than $10{\mu}m$ form an irregular surface on HA scaffolds, which prevents the osteoblast from adhering and proliferating on the surface of HA scaffold. Methods: In this study, three different groups were designed for comparison. In the first group (group A), conventional method was used, in which HA pellet was applied without surface pretreatment. The second group (group B) was given a HA pellet that has been coated with crystalline HA solution prior to application. In the third group (group C), the same method was used as the second group, where the pretreated HA pellet was heated ($1250^{\circ}C$, 1 hour) before application. Osteoblast-like cells ($2{\times}10^4$/mL) were scattered onto every pellet, then they were incubated in 5% $CO_2$ incubator at $37^{\circ}C$ for twelve days. During the first three days, osteoblast cells were counted using the hemocytometer daily. ALP activity was measured on the 3, 6, 9 and 12 culture days using the spectrophotometer. Results: Under SEM, group A showed a surface with numerous micropores, and group B revealed more rough crystal surface. Group C revealed a fused crystal appearance and flattened smooth surface. In proliferation and ALP activity of osteoblast cells, group C showed better results compared to group B. Group A which lacks pretreatment of the surface showed less osteoblast proliferation and ALP activity than group C, but showed better results than group B. Conclusion: We found that crystallized HA with heat treatment method enhances the osteoblasts proliferation and differentiation on the surface of HA pellets.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.559-564
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• 2009

Purpose: Surgical reconstruction of an ischial soft tissue defect presents a challenging problem owing to a high rate of recurrence, especially paraplegic patients. Although various muscle, musculocutaneous and fasciocuta - neous flaps have been used in the reconstruction of ischial soft tissue defect, it is still debated which type of flaps are the best. We had performed a relatively durable adductor magnus perforator island flap based on the perforators originated from the first medial branch of the profunda femoris artery for coverage of ischial soft tissue defect where was not a region universally reconstructed by perforator flap. Methods: From August 2005 until January 2008, the adductor magnus perforator island flap had been used for resurfacing of the ischial soft tissue defects in a series of 6 patients (4 male and 2 female). Ages ranged from 26 to 67 years (mean, 47.5 years), and follow - up period from 13 to 26 months (mean, 16.7 months). Causes were 4 pressure ulcers, 1 cellulitis and 1 suppurative keratinous cyst. Results: The sizes of these flaps ranged from 12 to 18 cm in length and 7 to 9 cm in width. The flaps survived in all patients. Marginal loss over the distal area of the flap by infection was noted in one patient, which was treated successfully with a subsequent split - thickness skin graft. Average thickness of the flap was 0.94 cm, which was more thicker than other perforator flaps. Long term follow - up showed a good flap durability. Conclusion: In planning a reconstructive option of ischial soft tissue defect, the adductor magnus perforator island flap is a relatively large cutaneous flap with a durable thickness. With proper patient selection, careful vascular dissection and postoperative management, we recommend this flap is a good and suitable option for coverage of the ischial soft tissue defect.