• Title/Summary/Keyword: bone and skin

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Reconstruction for the Soft Tissue Defect of Heel using Free Lateral Arm Neurosensory Flap (유리 외측 상박 감각신경 피판술을 이용한 종부 연부조직 결손의 재건)

  • Kim, Dong-Churl;Kim, Sang-Soo;Ha, Dae-Ho;Yoo, Hee-Jun;Lee, Dong-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.15-21
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    • 1999
  • Soft tissue defect on heel area of the foot present difficult problems particularly because of anatomic property of plantar surface of the foot. There is a paucity of available local tissue in the foot for coverage. In addition to having little expandable tissue, the foot's plantar surface has a unique structure, making its replacement especially challenging. Plantar skin is attached to the underlying bone by fibrous septa, preventing shear of the soft-tissue surfaces from the underlying skeleton. Plantar surface of foot is in constant contact with the environment. Protective sensibility also would be maintained or restored in the ideal reconstruction. So the ideal flap for reconstruction of the heel should include thin, durable hairless skin with potential for reinnervation. The aim of this article is to present a clinical experience of free lateral arm neurosensory flap for reconstruction of the heel. From March 1995 to December 1997, a total 16 lateral arm free flaps were performed to soft tissue defects on the weight-bearing area of the hindfoot. we used tibial nerve as recepient nerve in 11 and calcaneal branch of tibial nerve in 5 for restoration of sensibility of flap. All cases survived completely. A static two-point discrimination of 14 to 34mm was detected in the flap. Radial nerve palsy which was caused by hematoma in donor site occured in one case, but recorverd in 3 weeks later completely. In conclusion, the lateral arm free flaps are versatile, reliable and sensible cutaneous flap and especially indicated for soft tissue defect on plantar surface of the hindfoot which are not good indications for other better-known flaps.

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One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique

  • Cho, Jae-Young;Jang, Young-Chul;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Lee, Jong-Wook;Choi, Jai-Koo
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.118-123
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    • 2012
  • Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

Comparative Analysis of the Constituents of the Leaves and Roots of Rumex crispus and their Effects on the Differentiation of Human Osteoblast-like MG-63 Cells (소리쟁이 잎과 뿌리 성분 분석 및 사람 조골 유사 MG-63 세포 분화에 미치는 효과 비교)

  • Park, Heajin;Jeong, Jaehoon;Hyun, Hanbit;Kim, Jihye;Kim, Haesung;Oh, Hyun Il;Hwang, Hye Seong;Kim, Ha Hyung
    • YAKHAK HOEJI
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    • v.58 no.5
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    • pp.307-313
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    • 2014
  • Rumex crispus (curled dock), which is a perennial wild plant, has long been used as a laxative, astringent, and medicine to treat blood and skin diseases. We recently reported that the roots of R. crispus are an effective nutraceutical for bone. This study prepared ethanol extracts of the leaves and roots of R. crispus, and analyzed the major constituents using liquid chromatography and mass spectrometry. In addition, their effects on the proliferation and differentiation of human osteoblast-like MG-63 cells, such as cell viability, alkaline phosphatase (ALP) activity, collagen content, and mineralization, were compared. The chromatograms of the chemical constituents of the two extracts exhibited quite different profiles: quercetin and quercitrin were identified as major peaks in the leaf extract, whereas cinnamtannin B1 and procyanidin isomers were the major peaks for the root extract. Neither extract was cytotoxic at concentrations of < $25{\mu}g/ml$. ALP activity and collagen synthesis-which are markers of the early stage of osteogenesis-in MG-63 cells were significantly increased upon the addition of the root extract compared with the addition of the leaf extract. In contrast, the leaf extract had a more stimulatory effect on mineralization-which is marker of the late stage of osteogenesis-in MG-63 cells than did the root extract. In conclusion, extracts of both leaves and roots of R. crispus stimulated the bone-forming activity of osteoblasts; in particular, the root extract was more effective in the early stage of osteoblast differentiation, while the leaf extract was more effective in the late stage. This difference in anabolic activity may be due to differences in the constituents of the leaves and roots. The leaves and roots of R. crispus appear to complement each other as stimulators of bone formation.

An Analytical Study on Student's Physical Examination of Elementing and Seconding School in Korea (우리나라 초(初)·중(中)·고(高) 학생(學生) 신체검사결과(身體檢査結果)에 대한 분석연구(分析硏究))

  • Youn, Chong Duk
    • Journal of the Korean Society of School Health
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    • v.1 no.1
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    • pp.114-132
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    • 1988
  • Aiming to appraise student's health status and recommend improvement and strengthening of the school health services, statistical analysis of the results of health examination were done with summarized data which were collected nation-wide through the Ministry of Education. After analysis of data obtained, the results of the study summarized as follows; 1) Requested Adequate care Requested Adequate care showed from 5 % to 3% in 1962 and 1984 respectively. In sexes, Requested Adequate in girls (2.8%) more apparent than in boys (2.5%) 2) Eyes i) Weak vision, abnormal refraction of eyes (myopia, hypermetropia and astigmatism), eye diseases (trachoma, others) were found as shown in the Table 2, Figure 3. Weak vision and abnormal refraction of eyes showed from 2 % (Elementary), 5 % ( Secondary) to 4 % (Elementary), 14 % (Secondary) in 1962 and 1984 respectively. In both sexes, the older the age of students the more weak vision and abnormal refraction of eyes had rapidly increased especially in over 15-year old. ii) Eye diseases (trachoma, others) showed from 2% to age of students the more diseases had students. 3) Ear, nose and pharynx Hearing disturbance, ear diseases (otitis mediae, others), nose (empyema, hypertrophy) and pharynx diseases were found as following 1) Hearing disturbance was found from 0.3%(Elementary), 1 %(Secondary) to 0.05 % (Elementary), 0.4 % (Secondary) in 1962 and 1984 respectively, however, recently the older the age of students the more had students. ii) Ear diseases showed from 1.7 % (Elementary) 1.0 % (Secondary) to 0.3 %(Elementary), 0.5%(Secondary) in 1962 and 1984 respectively. iii) In diseases of the nose and pharynx, tonsilitis showed from 2.5% (Elementary), 3.5 % (Secondary) to 1.8 % ( Elementary). 2.5% (Secondary) in 1962 and 1984 respectively. 4) Skin Infectious skin diseases and other skin diseases were found from 1.5% to 0.6% in 1962 am 1984 respectively. 5) Teeth Dental caries (in milk and permanent teeth) and otner oral diseases are shown from 12 % (Elementary), 8%(Secondary) to 75%( Elementary), 25% (Secondary) in 1962 and 1984 respectively. 6) Other defects and diseases A relatively higher morbidity was shown in the tubercular diseases, in anemia, and in heart diseases among the tuberculous diseases, nodular diseases, Pleurisy, heart diseases, anemia, beriberi, hernia, neurasthenia, speech difficulty, mental disorders, bone dysformity, motion difficulty of extremities. In both sexes, tuberculous diseases were found almost equally in both sexes and anemia in girls was more apparent than in boys. Trying to provide more effective health services in schools : i) A better and more effective physical examination should be carried out in each school and prior to the physical examination, the qualified daily observation of children by teacher should be keenly practiced. ii) According to the results of the required annual physical examination the leading cause of morbidity were dental caries, myopia, angina and otitis mediae and fore these diseases follow up should be carried out. iii) For prevention and treatment of diseases and defects health education for students in the classroom as well as to parents is urgently requested.

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Production and Usage of Korean Human Information in KISTI (KISTI에 있어서 한국인 인체정보의 생산과 활용)

  • Lee, Sang-Ho;Lee, Seung-Bock
    • The Journal of the Korea Contents Association
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    • v.10 no.5
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    • pp.416-421
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    • 2010
  • The KISTI (Korea Institute of Science and Technology Information) began to produce the Korean human information called Visible Korean and Digital Korean since 2000 because there was no human information in Korea which could represent the physical characteristics of Korean human body. The Visible Korean consists of CT, MR, sectioned and segmented images of Korean human body. We obtained the serially sectioned images by grinding the Korean cadaver in horizontal direction and segmented these images by outlining the inner organs of human. We have produced the sectioned images of Korean male whole body, male head, and female pelvis in2008. The segmentation and 3D reconstruction of these images are now in proceeding. The Digital Korean consists of CT images of about 100 Korean cadavers. These CT images were segmented by individual bone, reconstructed to produce the 3D bone models and the skin surface model was also added. The mechanical properties of individual bones were obtained by measuring the property of individual bone sample. We have distributed these Korean human informations to users in domestic and abroad. About 70 institutes in domestic, and 20 institutes in abroad have used our data in research use and nearly 160 proceedings and articles were published since 2001. We think these human informations have a role of medical information infrastructure that could be used in the field of medical education, biomechanics, virtual reality etc.

Learning Needs in Patients undergoing Bone Marrow Transplantation (골수이식환자의 교육요구도)

  • 최소은
    • Journal of Korean Academy of Nursing
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    • v.30 no.2
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    • pp.514-526
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    • 2000
  • The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

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Effect of Codium Fragile Extract on Collagen Content and Collagen Cross-link Formation in Ovariectomized Rats (청각 추출물이 난소를 절제한 흰쥐의 collagen 함량 및 collagen 가교형성에 미치는 영향)

  • Park, Mi-Hwa;Kang, Sung-Rim;Kim, Mi-Hyang
    • Journal of Life Science
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    • v.17 no.7 s.87
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    • pp.931-936
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    • 2007
  • The aim of this study was to evaluate the effects of Codium Fragile(CF) extract on the collagen content and collagen cross-link content of the connective tissues, alkaline phosphatase activity and calcium levels of serum in ovariectomized estrogen-deficient rats. Three groups were surgically ovariectomized. The fourth group was sham operated. Sprague-Dawley female rats were randomly assigned to the following groups : sham-oper-ated rats(Sham), ovariectomized control rats (OVX-CON), ovariectomized rats supplemented with CF at 50 mg/kg body wt and 200 mg/kg body wt, respectively The CF were orally administrated at 1mLa day. The ovariectomy caused a decreasing in collagen content in bone, cartilage, skin and lung tissues. However CF groups, supplementation with Codium Fragile extract, increased in collagen contentin bone and cartilage tissues than OVX-CON group. Fyridinoline content in cartilage collagen was de-creased by ovariectomy but supplementation with the CF extracts was similarly increased to Sham. Alkaline phosphatase activity on serum of CF groups decreased than OVX-CON group. These results suggest that CF supplementation prevents post-menopausal bone loss, thus it may be used possibly to improve the quality of life in menopausal women.

Ipsilateral Dorsalis Pedis Vascularized Pedicle Flap in the Distal Leg and Foot

  • Yu, Chang Eun;Lee, Jun-Mo;Choi, Hee-Rack
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.52-56
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    • 2013
  • Purpose: We had proceeded seven iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defects and followed-up average for 5 years and 9 months to evaluate the survival rate, neurosensory function and cosmesis in final results. Materials and Methods: From January 1999 through October 2012, we have performed iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defect (average around $3.6{\times}2.4cm$) in 7 cases and average age was 41.6 years (21.5 to 59.0 years). Lesion site was posterior heel in 4 cases, distal anterior leg in 3 cases. Donor structure was the dorsalis pedis artery and the first dorsal metatarsal vessel and deep peroneal nerve in 3 cases and the dorsalis pedis artery and the first dorsal metatarsal vessel in 4 cases. Results: Seven cases (100%) were survived and defect area was healed with continuous dressing without skin graft. The sensory function in the neurovascular flap was restored to normal in 3 cases. Cosmesis was good and fair in 7 cases (85.7%). Conclusion: Ipsilateral dorsalis pedis vascularized pedicle flap in the distal leg and foot is one of the choice to cover the exposed bone and soft tissues without microsurgical procedure.

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Reconstruction of large oroantral defects using a pedicled buccal fat pad

  • Yang, Sunin;Jee, Yu-Jin;Ryu, Dong-mok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.7.1-7.5
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    • 2018
  • Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

Macrophage Activation Syndrome Triggered by Herpes Viral Infection as the Presenting Manifestation of Juvenile Systemic Lupus Erythematosus (헤르페스 바이러스 감염으로 발생한 대식 세포 활성 증후군을 첫 증상으로 한 소아 전신 홍반 루푸스)

  • Noh, Ji Hye;Jeong, Do Young;Jeon, In Su;Kim, Hwang Min
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.210-215
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    • 2015
  • Macrophage activation syndrome (MAS) is a rare complication in systemic lupus erythematosus (SLE) that can be triggered by infections. Due to the fact that MAS may mimic clinical features of underlying rheumatic disease, or be confused with an infectious complication, its detection can prove challenging. This is particularly true when there is an unknown/undiagnosed disease; and could turn into an even greater challenge if MAS and SLE are combined with a viral infection. A-14-year-old female came to the hospital with an ongoing fever for 2 weeks and a painful facial skin rash. Hepatomegaly, pancytopenia, increased aspartate aminotransferase, elevated serum ferritin and lactate dehydrogenase were reported. No hemophagocytic infiltration of bone marrow was reported. The patient was suspected for hemophagocytic lymphohistiocytosis. Her skin rashes were eczema herpeticum, which is usually associated with immune compromised conditions. With the history of oral ulcers and malar rash, positive ANA and low C3, C4 and the evidence of hemolytic anemia, she was diagnosed as SLE. According to the diagnostic guideline for MAS in SLE, she was diagnosed MAS as well, activated by acute HSV infection. After administering steroids and antiviral agent, the fever and skin rash disappeared, and the abnormal laboratory findings normalized. Therefore, we are reporting a rare case of MAS triggered by acute HSV infection as the first manifestation of SLE.