• Archives of Plastic Surgery
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• v.44 no.1
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• pp.80-84
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• 2017

Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.89-93
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• 2014

Background: To refine facial transplantation techniques and achieve sound results, it is essential to develop a suitable animal model. Rat is a small animal and has many advantages over other animals that have been used as transplantation models. The purpose of this study was to describe a rat hemifacial transplantation model and to verify its convenience and reproducibility. Methods: Animals used in this study were Lewis rats (recipients) and Lewis-Brown Norway rats (donors). Nine transplantations were performed, requiring 18 animals. The hemifacial flap that included the ipsilateral ear was harvested based on the unilateral common carotid artery and external jugular vein and was transferred as a single unit. Cyclosporine A therapy was initiated 24 hours after transplantation and lasted for 2 weeks. Signs of rejection responses were evaluated daily. Results: The mean transplantation time was 1 hour 20 minutes. The anatomy of common carotid artery and external jugular vein was consistent, and the vessel size was appropriate for anastomosis. Six of nine allografts remained good viable without vascular problems at the conclusion of study (postoperative 2 weeks). Conclusion: The rat hemifacial transplantation model is suitable as a standard transplantation training model.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.3
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• pp.253-263
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• 1995

Microsurgical vascularized bone transfer has the disadvantages of limitation of available donor sites, loss of donor function, and the possibility of donor site defects or deformity. To overcome these shortage of current microsurgical tissue transfer, the method of creating the neovascularized free flap has been introduced. Potentially, this technique must be an innovation in providing the free vascularized bone grafts that are not limited by natural vascular anatomy. But, as could be imagined technique resulted in unavoidable donor bone defect and additional operation for harvesting the autologous bone. The purpose of this study was to evaluate the efficacy of demineralized allogeneic bone as a possible substitute for autologous bone in fabricating the neo-osseous flap. By histologic, microangiographic and radioisotope method, the viability and vascularity of neo-osseous flap, which has been fabricated using allogeneic bone or autologous bone, was assessed in rat model. After 6 weeks, demineralized allogeneic bone showed consistent bone formation and neovascularization. The clinical and microscopic findings of demineralized allogeneic bone group were inferior to those of autogenous bone with regard to bone regeneration. The amount of bone blood floow per dry weight of demineralized allogeneic bone group was significantly higher than that of autogenous bone, even higher that of control intact iliac bone. In conclusion, findings supported that allogeneic bone could be the potential substitute for autologous bone source in creating a prefabricated neo-osseous flap.

• Archives of Plastic Surgery
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• v.45 no.3
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• pp.214-221
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• 2018

Clarification is needed regarding the definitions and classification of groove and hollowness of the infraorbital region depending on the cause, anatomical characteristics, and appearance. Grooves in the infraorbital region can be classified as nasojugal grooves (or folds), tear trough deformities, and palpebromalar grooves; these can be differentiated based on anatomical characteristics. They are caused by the herniation of intraorbital fat, atrophy of the skin and subcutaneous fat, contraction of the orbital part of the orbicularis oculi muscle or squinting, and malar bone resorption. Safe and successful treatment requires an optimal choice of filler and treatment method. The choice between a cannula and needle depends on various factors; a needle is better for injections into a subdermal area in a relatively safe plane, while a cannula is recommended for avoiding vascular compromise when injecting filler into a deep fat layer and releasing fibrotic ligamentous structures. The injection of a soft-tissue filler into the subcutaneous fat tissue is recommended for treating mild indentations around the orbital rim and nasojugal region. Reducing the tethering effect of ligamentous structures by undermining using a cannula prior to the filler injection is recommended for treating relatively deep and fine indentations. The treatment of mild prolapse of the intraorbital septal fat or broad flattening of the infraorbital region can be improved by restoring the volume deficiency using a relatively firm filler.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.194-199
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• 2023

Moderate soft-tissue defects need stable coverage, ideally with tissue of similar characteristics and low donor site morbidity. We propose a simple technique for the coverage of moderate skin defects in the limbs. It allows intraoperative transformation of a propeller perforator flap (PPF) into a keystone design perforator flap (KDPF) in cases of unsatisfying perforator vessel or in cases of unpredictable intraoperative events. Between March 2013 and July 2019, nine patients with moderate soft-tissue defects (mean defect size 4.5 × 7.6 cm) in the limbs (two on the upper limbs and seven on the lower limbs) were covered using this technique. We performed four PPFs and five KDPFs. The mean follow-up was 5 months. There was one complication, partial distal tip necrosis in a PPF located in the leg, which healed by secondary intention within 3 weeks. The donor site was closed directly in all cases. No functional impairments were noted regardless of the perforator flap utilized. This technique enables us to employ flexible surgical strategies and allows us to make adjustments based on the patient's vascular anatomy.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.469-473
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• 2023

Anomalies of anterior cerebral artery (ACA) include aplasia, hypoplasia and variations in number. Magnetic resonance angiography (MRA) is a non-invasive diagnostic technique for assessment of anomalies of cerebral arteries. The aim of the study was to determine the role of MRA in detection of variants of ACA in adults. This study is an observational retrospective study. This study included forty-nine adult cases (28 males and 21 females), mean age 48±12.9 SD with anomalies of ACA in MRA. Magnetic resonance imaging of the brain and MRA were done to all patients. Cerebral MRA and magnetic resonance images were evaluated for frequency and distribution of variants of anterior cerebral arteries, associated aneurysms and infarctions. Odds ratios (ORs) and relative risk were calculated to determine risk of occurrence of cerebral infarctions in patients with anomalies of ACA. Hypoplasia of ACA was the commonest anomaly of ACA (51% of cases). Risk of occurrence of cerebral infarctions was higher in cases with azygos variant (OR, 3.3; P=0.35) than in those with hypoplastic ACA (OR, 2; P=0.58). MRA was highly reliable in identification of different variants of ACA and concomitant vascular changes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.7.1-7.9
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• 2017

Background: This study was to investigate the effect of biomechanical stimulation on osteoblast differentiation of human periosteal-derived stem cell using the newly developed bioreactor. Methods: Human periosteal-derived stem cells were harvested from the mandible during the extraction of an impacted third molar. Using the new bioreactor, 4% cyclic equibiaxial tension force (0.5 Hz) was applied for 2 and 8 h on the stem cells and cultured for 3, 7, and 14 days on the osteogenic medium. Biochemical changes of the osteoblasts after the biomechanical stimulation were investigated. No treatment group was referred to as control group. Results: Alkaline phosphatase (ALP) activity and ALP messenger RNA (mRNA) expression level were higher in the strain group than those in the control group. The osteocalcin and osteonectin mRNA expressions were higher in the strain group compared to those in the control group on days 7 and 14. The vascular endothelial growth factor (VEGF) mRNA expression was higher in the strain group in comparison to that in the control group. Concentration of alizarin red S corresponding to calcium content was higher in the strain group than in the control group. Conclusions: The study suggests that cyclic tension force could influence the osteoblast differentiation of periosteal-derived stem cells under optimal stimulation condition and the force could be applicable for tissue engineering.

• The Korean Journal of Physiology and Pharmacology
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• v.5 no.4
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• pp.343-351
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• 2001

This study was undertaken to investigate the mechanism of lipopolysaccharide (LPS) and nitric oxide (NO) as a regulator of vascular smooth muscle cell (VSMC) proliferation. VSMC was primarily cultured from rat aorta and confirmed by the immunocytochemistry with anti-smooth muscle myosin antibody. The number of viable VSMCs were counted, and lactate dehydrogenase (LDH) activity was measured to assess the degree of cell death. Concentrations of nitrite in the culture medium were measured as an indicator of NO production. LPS was introduced into the medium to induce the inducible nitric oxide synthase (iNOS) in VSMC, and Western blot for iNOS protein and RT-PCR for iNOS mRNA were performed to confirm the presence of iNOS. Inhibitors of iNOS and soluble guanylate cyclase (sGC), sodium nitroprusside (SNP) and L-arginine were employed to observe the action of LPS on the iNOS-NO-cGMP signalling pathway. LPS and SNP decreased number of VSMCs and increased the nitrite concentration in the culture medium, but there was no significant change in LDH activity. A cell permeable cGMP derivative, 8-Bromo-cGMP, decreased the number of VSMCs with no significant change in LDH activity. L-arginine, an NO substrate, alone tended to reduce cell count without affecting nitrite concentration or LDH level. Aminoguanidine, an iNOS specific inhibitor, inhibited LPS-induced reduction of cell numbers and reduced the nitrite concentration in the culture medium. LY 83583, a guanylate cyclase inhibitor, suppressed the inhibitory actions of LPS and SNP on VSMC proliferation. LPS increased amounts of iNOS protein and iNOS mRNA in a concentration-dependent manner. These results suggest that LPS inhibits the VSMC proliferation via production of NO by inducing iNOS gene expression. The cGMP which is produced by subsequent activation of guanylate cyclase would be a major mediator in the inhibitory action of iNOS-NO signalling on VSMC proliferation.

• Journal of Life Science
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• v.9 no.2
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• pp.127-135
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• 1999

Gentiana scabra Bunge var buergeri Max, can be widely used such as cut-flower, ornamental and medicinal plant among the native plants. Microscopic and Scanning electron microscopic observation plant were carried out to estimates the characteristics correlated with germinability and germination process, and the results were as follows. The seeds were germinated just after harvest, and it means that there is no or little dormancy of the seeds. Matured seeds showed higher germinability than those of immatured. As the storage period was longer, immatured seeds showed shorter longevity than those of matured. The average longevity was about 190 days. According to the observation results of morphological changes during the germination, seed coat was expanded with water absorption immediately after seeding, and radicals were observed 2 days after seeding. Root hairs were formed behind the growing tip of the root on 4 days after seeding and cotyledon were unfolded on 6 days after seeding. In the microscopic observation of leaf tissues, it could be easily distinguished between midrib, and leaf blade, and also observed upper epidermis, palisade parenchyma and spongy parenchyma consisted as a sing1e layer. Palisade parenchyma was consisted of a single layer of cell. Stomata were restricted lower surface, arranged as anamocytic type, and surrounded by guard cells. In the microscopic anatomy of stem were consisted of cortical layer, forming a single layer of epidermis and parenchyma, and vascular bundle which was consisted of continuous cylinder of vascular tissues.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.39 no.2
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• pp.146-157
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• 1994

Wasong(Orostachys japonicus A. Berger) has been used as anti-cancer medicinal plants from ancient time. This experiment was conducted to obtain some fundamental informations concerning anatomical study, germination test, soil analysis of indigenious districks, adaptaion of soil for wasong. The leaf of wasong was xerotype with spine, mesophyl chloroplast is dense surrounded vascular bundle, with a many large water storage tissue without chloroplast, and was bifacial stomata leaf type. The stem of wasong was amphicribral vascular bundle, central cylinder was cylinder type and protostele. Root was polarch type, potoxylem of it's was arranged in ring shape of annulation and metaxylem. The structure of flower was cymose, was caylyx of 5 sepals, corolla of 5 petals, roecium of 10 stames, ovules of five, placentation parietal, ovary superior, axile placenta. The optimum temperature for seed germination was $25^{\circ}C$ under light and germination percentage was 22.5%. Dormancy breaking was effective for 6-8 days at 5$^{\circ}C$ and at 100 ppm level of $GA_3$ The soil analysis of wasong local districks, content of available $P_2O_5$, Ca were higer than optimal level of upland and C.E.C., exchangeable k was not significantly different of that, but exchangeable magnesium was very low. The growth of wasong was affected draining regardless soil combination treatment.