Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.
Background Little is known concerning hair diameter variation within the safe donor area for hair transplantation surgery. Thicker or thinner hair may be needed, depending on the recipient area, hairline design, and the purpose of surgery. Methods Twenty-seven patients (7 men and 20 women; mean age, 28 years; range, 20-47 years) were included in this study. The midoccipital point was used as the reference point on the horizontal plane at the upper border of the helical rim. The target area width was 15 cm (7.5 cm to the right and left of the reference point) and the height was 8 cm (2 cm above and 6 cm below the reference point). The study area was divided horizontally into 3 5-cm sections (A, B, C) and vertically into 4 2-cm sections (1-4), creating a total of 12 zones. Ten anagen hairs were randomly obtained from each zone and their diameters were measured. Results Hair diameter in the 4 vertical sections varied significantly, gradually decreasing from sections 1 (superior) to 4 (inferior) in all 3 horizontal sections (A, B, and C). Conclusions Our results suggest that sections 1 and 2 of the occipital safe donor area would be useful for obtaining thicker hair, such as in procedures to treat male- and female-pattern hair loss, whereas hair from zones 3 and 4 could be useful for transplantation surgery requiring thinner hair, such as eyebrows, eyelashes, and female hairline correction. Our results may be clinically valuable for planning hair transplant surgery and choosing the optimal donor region.
Kim, Dong-Hoon;Lee, Youn-Su;Oh, Keon-Bong;Hwang, Seong-Soo;Im, Gi-Sun;Park, Jin-Ki
Reproductive and Developmental Biology
/
v.35
no.3
/
pp.313-317
/
2011
This study was conducted to examine the effect of oocyte donor age and micromanipulation medium on the development of mouse cloned embryos receiving cumulus cells. Mouse oocytes were obtained from 6 to 11 week-old mice BDF1 female mice(experiment 1) and cumulus cells were used as donor cells. Micromanipulation procedures for nuclear transfer(NT) were performed in FHM, M2 or Hepes-buffered TCM199(TCM199) medium(experiment 2). After nuclear transfer, the reconstructed oocytes were activated by 10 mM $SrCl_2$ in Ca-free CZB medium in the presence of 5 II ${\mu}$g/ml cytochalasin B for 5 h and cultured in KSOM medium for 4 days. In experiment 1, the survival rate of oocytes after injection of cumulus cells were significantly(p<0.05) lower in oocytes from 6~7 week-old mice(53.3%) than in oocytes from 8~9(80.9%) and 10~11 week-old mice(77.1%). In experiment 2, the survival rate of oocytes after cell injection were significantly(p<0.05) higher in FHM and M2 medium(71.7% and 76.9%) than in TCM199 medium(51.2%). The activation rates of cloned embryos were not different among the micromanipulation media. However, the embryos developed to blastocyst stage were significantly(p<0.05) higher in FHM medium(13.9%) than in M2 and TCM199 medium(0.0% and 0.0%). In conclusion, the present study suggest that oocytes from above 8 week-old mice are superior to oocytes from 6~7 week-old mice as a source of recipient cytoplasm and FHM is superior to M2 and TCM199 as a micromanipulation medium for mouse somatic cell cloning.
Purpose: Metabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed. Methods: We retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated. Results: The post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period. Conclusion: Our results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.
Young Jun Kim;Woo Young Choi;Ji Seon Cheon;Min Hyub Choi
Archives of Plastic Surgery
/
v.50
no.3
/
pp.233-239
/
2023
Background Trunk defects can occur because of surgical site infections after spinal surgery, resection of malignant tumors, or trauma. Herein, we present our experience of using intercostal artery perforator (ICAP) flaps to reconstruct trunk defects without noteworthy complications. Fourteen patients underwent reconstruction with ICAP flaps between March 2015 and March 2019. Methods Patients' data, including age, sex, the cause of the defect, defect size, perforator location, flap size, complications, and follow-up period, were retrospectively reviewed. The mean age of the patients was 56.5 years (range, 19-80 years). All operations were performed after the results of bacterial culture from the wound showed no microbial growth. We found reliable perforators around the defect using Doppler ultrasonography. The perforator flaps were elevated with a pulsatile perforator and rotated in a propeller fashion to the defects. We performed five dorsal and two lateral ICAP flaps. The mean flap dimensions were 12 × 5.5 cm2 (range, 6 × 5 to 18 × 8 cm2). Results Primary closure of the donor site was performed. Marginal congestion was observed as a complication in one case, but it healed with no need for revision. The mean follow-up period was 8 months. All patients were satisfied with the surgical outcomes. Conclusion ICAP flaps can be easily mobilized, thereby reducing donor site morbidity without sacrificing the underlying muscles for trunk reconstruction. Therefore, these flaps are useful options for the reconstruction of trunk defects.
Purpose: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. Materials and Methods: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. Results: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. Conclusion: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle.
Production of calves after transfer of nuclear transplant embryos is the latest technology to be applied in commercial livestock breeding. The objective of this study was to establish an efficient procedure to produce offsprings from nuclear transplant embryos. The fusion rates (72.7% vs. 80.8%), cleavage rates (62.5% vs. 71.4%) and rates of development in vitro (12.0% vs. 15.2%) of nuclear transplant embryos were not significantly different between 30 and 40h maturation age of cytoplast. The in vivo and in vitro-derived embryos as nuclei donor were used in this system of bovine nuclear transplantation. Fusion rates of nuclear transplant embryos were not significantly different between in vivo and in vitro-derived embryos (73.0 and 79.2%, respectively). The percentage of embryos reaching the morulae or blastocysts were 21.8% for in vivo-derived embryos and 11.9% for in vitro-derived embryos (p<0.01). Pregnancy rates after embryo transfer of nuclear transplant embryos were not significantly different between in vivo and in vitro-derived embryos (45.9 and 40.5%, respectively). However, calving rates after embryo transfer of nuclear transplant embryos were significantly higher in the in vivo-derived embryos than in vitro (p<0.01). Further research for age of cytoplast and use of in vitro-derived embryos as nuclei donor is required in this system. In conclusion, these results clearly show that the use of in vitro-derived oocytes as recipient cytoplast can improve the nuclear transplant system for genetic progress in cattle.
This study was designed to evaluate the degree of the anxiety and discomfort experienced by first-time donors in platelet donation. The subject of this study was 309 first-time platelet donors visiting apheresis unit of St. Mary hospital in Seoul. The data was collected from Questionnaire during period of 28 April to 10 September 1999. The statistical methods used were t-test. ANOVA and stepwise multiple regression. The results were as follows. 1. The most common group were 21-30 years of age and soldier of job. 2. The mean scores of the platelet donor's anxiety was $1.60\pm0.32$. 3. The mean scores of platelet donor's discomfort was $1.72\pm0.44$. 4. The variables influencing anxiety were the physical condition. the level of education and donation experience. 5. The variables influencing discomfort were the job. diet before donation and physical condition. As the result above. the student group of the first time platelet donor experienced highest anxiety. It is important to assess the physical condition and diet before donation for more comfortable platelet donation. Furthermore. the developments of nursing interventions are required to reduce anxiety and discomfort of platelet donors.
Both of latissimus dorsi and rectus abdominis muscles are workhorse for various reconstructive surgeries. These muscle flaps have been used widely for soft tissue coverage, tissue augmentation, and functional muscle transfer. However, the traditional method for muscle harvest requires a long incision that often results in an unsightly scar and becomes the main concern of the patient. The purpose of this study is to introduce our clinical experience of endoscopic harvest of latissimus dorsi muscle and rectus abdominis muscle, and to make comparison with traditional harvest of these two muscle flaps. Of the 13 rectus abdominis muscles free flaps, 6 muscles were harvested traditionally and 7 muscles were harvested with endoscopic assistance. Of the 21 latissimus dorsi muscle free flaps, 12 muscles were harvested traditionally and 9 muscles were harvested with endoscopic assistence. Follow up period was between 6 months and 24 months. The patients age ranged from 7 to 70 years old. The result revealed no statistically significant differences in the amount of intraoperative bleeding, incidence of postoperative hematoma and seroma, and the incidence of donor-site wound infection. However, patients feel less pain and start earlier and better movement after the operation with endoscopically assisted harvest. This technique is easy to learn, is safe, and can reduce substantially the donor site morbidity comparing traditional harvesting technique.
Purpose : The aim of this study was to evaluate the bone mineral density of iliac and tibial bone which are frequently selected as autogenic bone graft donor sites, and to evaluate the efficiency of this method as a guideline for the selection of bone graft donor site. Materials and Methods : In this study 61 male and 70 female volunteers at Chungbuk National University Hospital were involved between Jan. 1998 to Sept. 1999. We measured bone mineral density of the iliac and the tibial bone using dual energy X-ray absorptiometry. We evaluated the data using the SAS system for Windows and bone mineral density of the lumbar was used for control. Results : Age showed the highest correlation in correlation matrix between physical and bone variables. Height and weight showed lower correlation of linear increment. In man, the change of bone density according to age demonstrated linear decrease irrespective of the lumbar, ilium, and tibia. In woman, the change of bone density according to age showed cubic form, which increased in the third and forth decade. So it had a peak bone mass on about 35 year-old, thereafter, the change of bone density slowly decreased until 50 year-old, but it rapidly decreased after 50 year-old and it slowly decreased again after 65 year-old. Both in all subjects and subject with osteoporosis, the change of bone mineral density according to age showed statistically significant decrease in lumbar and tibia, but ilium was irrespective. Conclusion : In patients of aged or with osteoporosis, ilium demonstrated less tendency of decrease in bone mineral density than tibia. So this preliminary study suggested that ilium seemed better donor site for autogenic bone graft than tibia.
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