الملخص
BACKGROUND: Adipose tissue damage of cryopreserved fat after autologous fat transfer is inevitable in several processes of re-transplantation. This study aims to compare and analyze the survivability of adipocytes after thawing fat cryopreserved at -20degrees C by using thawing methods used in clinics. METHODS: The survival rates of adipocytes in the following thawing groups were measured: natural thawing at 25degrees C for 15 minutes; natural thawing at 25degrees C for 5 minutes, followed by rapid thawing at 37degrees C in a water bath for 5 minutes; and rapid thawing at 37degrees C for 10 minutes in a water bath. The survival rates of adipocytes were assessed by measuring the volume of the fat layer in the top layers separated after centrifugation, counting the number of live adipocytes after staining with trypan blue, and measuring the activity of mitochondria in the adipocytes. RESULTS: In the group with rapid thawing for 10 minutes in a water bath, it was observed that the cell count of live adipocytes and the activity of the adipocyte mitochondria were significantly higher than in the other two groups (P<0.05). The volume of the fat layer separated by centrifugation was also measured to be higher, which was, however, not statistically significant. CONCLUSIONS: It was shown that the survival rate of adipocytes was higher when the frozen fat tissue was thawed rapidly at 37degrees C. It can thus be concluded that if fats thawed with this method are re-transplanted, the survival rate of cryopreserved fats in transplantation will be improved, and thus, the effect of autologous fat transfer will increase.
الموضوعات
Adipocytes , Adipose Tissue , Autografts , Baths , Cell Count , Centrifugation , Cryopreservation , Fats , Mitochondria , Survival Rate , Trypan Blue , Waterالملخص
The name of author should be corrected as the following: from "Min Hwang" to "So Min Hwang".
الملخص
In this article, on page 173, the title has been spelled incorrectly.
الملخص
PURPOSE: We used the retroauricular area skin as an alternative full-thickness skin donor site in the hand reconstruction surgery. METHODS: From January 2006 to March 2013, 55 patients observed more than 1 year, were recruited for the study. In case of requiring the skin graft on hand, we grafted skins were harvested from the retroauricular area on hand. To assess the subjective and objective satisfaction, the patients themselves and three doctors compared the skin graft area's color with adjacent skin and estimated the donor site scar on a five-point scale. RESULTS: A partial necrosis was seen in one case who received skin graft because of a burn scar contracture, but it was cured with conservative treatment. In other cases, the skin graft was well taken without any specific problems. The retroauricular skin graft showed good color match with adjacent skin and less pigmentation. Donor site scar was not noticeable. As a result, the patient's subjective satisfaction (4.07) and doctor's objective satisfaction (4.18) about skin graft were very good. And the patient's subjective satisfaction (4.93) and doctor's objective satisfaction (4.98) about donor site scar were also very good. CONCLUSION: We obtained the favorable result and the patients satisfaction by using the retroauricular area as a full thickness skin graft donor site in hand.
الموضوعات
Humans , Burns , Cicatrix , Contracture , Hand Injuries , Hand , Hyperpigmentation , Necrosis , Pigmentation , Skin , Tissue Donors , Transplantsالملخص
Blepharoplasty is one of the most common anti-aging operations. Although rare, complications such as ectropion may occur. Thus, we introduced an operative technique to prevent ectropion of the lower lid after blepharoplasty. From January 2012 to August 2013, we performed a nonincisional suspension suture (NISS) technique for 30 patients who visited our clinic for lower blepharoplasty. These patients had a distance of greater than 7 mm on the distraction test and were suspected of having horizontal lid laxity. We performed a slit incision 3 mm superior to the junction between the lateral epicanthus and the orbital bone during lower blepharoplasty. We passed a 7-0 nylon suture through the subcutaneous layer and the orbicularis oculi muscle. Then, we punctured the tarsal plate at the lateral limbus and fixed it to the lateral orbital rim by puncturing the periosteum. We tied a suspension knot through the slit incision. Thirty patients had satisfactory results without major complications, such as scleral exposure or ectropion. The NISS technique could be an effective method by which to prevent postoperative ectropion in cases with a mild to moderate degree lower lid laxity. The use of a NISS procedure is also a simple surgical technique, which saves time and is minimally invasive.
الموضوعات
Humans , Blepharoplasty , Ectropion , Eyelids , Nylons , Orbit , Periosteum , Minimally Invasive Surgical Procedures , Suturesالملخص
BACKGROUND: Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. METHODS: A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. RESULTS: Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. CONCLUSIONS: Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.
الموضوعات
Animals , Humans , Rats , Biopsy , Carrier Proteins , Cholesterol , Embolism, Fat , Fats , Jugular Veins , Kidney , Lipectomy , Lung , Physiological Phenomena , Subcutaneous Fat , Triglyceridesالملخص
BACKGROUND: Lipomas can be categorized into deep and superficial lipomas according to anatomical depth. Many cases of forehead lipomas are reported to be deep to the muscle layer. We analyze ultrasound in delineating depth of forehead lipomas. METHODS: A retrospective review was performed for all patients who underwent excision of forehead lipomas between January 2008 and March 2013 and for whom preoperative ultrasound study was available. Sensitivity and specificity of ultrasound imaging was evalauted against depth finding at the time of surgical excision. RESULTS: The review identified 42 patients who met the inclusion criteria. Preoperative ultrasound reading was 18 as deep lipomas and 24 as superficial. However, intraoperative finding revealed 2 of the 18 deep lipomas to be superficial and 13 of the 24 superficial lipomas to be deep lipomas. Overall, ultrasonography turned out to be 69% (29/42) accurate in correctly delineating superficial versus deep lipomas. CONCLUSION: Lipomas of the forehead tend to be located in deeper tissue plane compared to lipomas found elsewhere in the body. Preoperative ultrasonography of lipomas can be helpful, but was not accurate in identifying the depth of forehead lipomas in our patient population. Even if a forehead lipoma is found to be superficial on ultrasound, operative planning should include the possibility of deep lipomas.
الموضوعات
Humans , Forehead , Lipoma , Retrospective Studies , Sensitivity and Specificity , Ultrasonographyالملخص
Keloid is a scar tissue that undergoes recovery and excessive growth over the original wounds when the collagen is excessively accumulated in the dermis during the wound healing process. The common sites of keloid occurrence include the anterior thorax, shoulder, upper extremities and ear. To our knowledge, however, there are few cases of keloid that occurs in the axilla. In addition, there are fewer cases of keloid that bilaterally occurs at the operated sites postoperatively in individuals with no past or family history. 21-year-old male had undergone subdermal shaving for the management of osmidrosis but had not received appropriate scar management during the military service. He visited us with a keloid-like scar formed in the bilateral axillae. We excised the scar tissue and treated it with local steroid injection and postoperative axilla compression. In histopathological report, no flattening of the overlying epidermis, and presence of keloid collagen which confirms diagnosis of keloid. We report our clinical experience with a rare case of keloid occurring in the axilla and treatment process.
الموضوعات
Humans , Male , Young Adult , Apocrine Glands , Axilla , Cicatrix , Collagen , Dermis , Diagnosis , Ear , Epidermis , Keloid , Military Personnel , Shoulder , Thorax , Upper Extremity , Wound Healing , Wounds and Injuriesالملخص
BACKGROUND: Burn injuries of the extremity can result in cosmetically offensive appearance. Postburn scar can improve by the combination of tangential excision and thin split-thickness skin graft. METHODS: From January 2005 and December 2012, 17 patients (10 males and 7 females) with postburn scar of the extremity underwent the combined techniques. The median time from initial injury to surgery was 66.2 months (range: 11-288 months). In the operation, burn scar was excised until viable dermis could be observed using electrical dermatome, after which thin split thickness skin graft was performed. RESULTS: Tangential excision and thin split thickness skin graft gave excellent grafting results without the need of reoperation. Depigmentation in the majority of patients were recovered within a year by the operation of thin split thickness skin graft. Recovery of range of motion and cosmetic results were good in all patients. CONCLUSIONS: Tangential excision and thin split thickness skin graft are a good way of the reconstruction of deformed and depigmented skin from burns on extremity.
الموضوعات
Humans , Male , Burns , Cicatrix , Dermis , Extremities , Range of Motion, Articular , Reoperation , Skin , Transplantsالملخص
BACKGROUND: Depressed scars are usually corrected using subcutaneous fillers such a dermal fat grafting or an autologous fat grafting. But, fillers are absorbed over time and cannot be appropriately used for the correction of large or deep depressed scars. Therefore, we tried new methods to correct challenging cases of deep depressed scars. METHODS: From 2005 to 2013, deep depressed scar were corrected in 10 patients. The location of the scars were as follows: 6 neck, 4 lower extremities. Preoperative marking was done involving the scar on the skin in an oval shape including the long axis of relaxed skin tension line, and the epithelium of the scar was removed. Both ends of the dermal layer of the residual scar were dissected and then isolated from the subcutaneous layer of the adjacent skin. Then, we folded both ends of the flap like hinge flaps and thereby appropriately restored the depressed part of the dermal layer. And we directly closed skin for scar revision. RESULTS: All ten patients had a good result and satisfaction without complication, such as wound infection, dehiscence, at a mean follow-up of seven months. Correction of depression area made the depressed scar less noticeable. Moreover, the problems like donor morbidity, color and texture matching in case of using our techniques, are not issued. CONCLUSIONS: We folded residual scar tissue like a hinge flap in the correction of depressed scar. We obtained good outcomes and report our new methods and their outcomes with a review of literatures.
الموضوعات
Humans , Axis, Cervical Vertebra , Cicatrix , Depression , Epithelium , Follow-Up Studies , Lower Extremity , Methods , Neck , Skin , Tissue Donors , Transplants , Wound Infectionالملخص
Cystadenocarcinoma of the salivary gland is a rare malignant tumor. It was first defined as papillary cystadenocarcinoma in the 1991 World Health Organization (WHO) classification, and it was reclassified as cystadenocarcinoma in the 2005 WHO classification. It is a low-grade neoplasm that features slow growing and predominantly cystic growth. We report a case of cystadenocarcinoma occurring on the parotid gland of a 61-year-old female patient presenting palpable mass on her left cheek. Preoperative examination may not reveal typical malignant characteristics. Such as in our case, the differential diagnosis between cystadenocarcinoma and benign lesion is difficult occasionally. We discuss the clinical and histopathological features of cystadenocarcinoma with the review of the literature.
الموضوعات
Female , Humans , Middle Aged , Cheek , Cystadenocarcinoma , Cystadenocarcinoma, Papillary , Diagnosis, Differential , Parotid Gland , Salivary Glands , World Health Organizationالملخص
BACKGROUND: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. METHODS: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. RESULTS: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. CONCLUSION: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.
الموضوعات
Humans , Facial Bones , Fluoroscopy , Fractures, Closed , Mandible , Nasal Bone , Prospective Studies , Zygoma , Zygomatic Fracturesالملخص
PURPOSE: The lessor saphenous vein is an anatomical index in various surgical methods involving an approach to the popliteal fossa. However, occasionally, there have been some cases where the surgical process was difficult because the lessor saphenous vein was not found in the popliteal fossa during the operation process. The aim of this study is to determine the frequency of the anatomical variation of lessor saphenous vein not found in the popliteal fossa with a review of the literature. MATERIALS AND METHODS: This study was conducted on 83 cases of selective neurectomy for hypertrophic calf performed in our clinic from March 1997 to June 2013. There were 42 patients, with a mean age of 32.8 years old. We confirmed the existence of the lessor saphenous vein in the popliteal fossa during the operation process. RESULTS: Among 83 cases during this study period, the lesser saphenous vein was not found in four cases. In one patient, no lesser saphenous vein was found on either side of the popliteal fossa, and in two patients, no lesser saphenous vein was found on the left side of the popliteal fossa. As a result, the frequency of variation was found to be 4.8%. CONCLUSION: Due to the anatomical variation of the lessor saphenous vein, it may not be found in the midline of the popliteal fossa. Based on the literature review, several possibilities for failure to observe the lesser saphenous vein could be suggested. If surgeons are well aware of these possibilities, the steadier operation could be performed.
الموضوعات
Humans , Anatomic Variation , Methods , Popliteal Vein , Saphenous Veinالملخص
PURPOSE: Although a fasciocutaneous perforator artery as a vascular pedicle has previously been shown to be predominant in the anterolateral thigh (ALT) flap, recent studies have shown that a myocutaneous perforator artery is predominant. We have attempted to attain a clinical understanding of the vascular variations in the ALT flap. MATERIALS AND METHODS: We confirmed the origin of a perforator artery in 11 cases of ALT flap. We then reviewed the variations of the descending branch of the lateral femoral circumflex artery, known as the major origin of the flap, and the overall variations associated with an ALT flap. RESULTS: In a total of 11 cases, there were 18 perforator arteries of the ALT flaps. In addition, there were 9 fasciocutaneous perforator arteries and another 9 myocutaneous ones. However, depending on the origin, there was great variability in the perforator artery. That is, there were unique variants in the descending branches of the lateral femoral circumflex artery, the major origin of the perforator artery, in 3 of the total 11 cases. CONCLUSION: Our results showed that (1) a perforator artery accounts for the high proportion of fasciocutaneous ones, (2) a perforator artery might not originate from the descending branch of the lateral femoral circumflex artery and (3) there might be unique variants in the descending branch. If considering this, surgeons would successfully elevate an ALT flap.