Reconstruction in the head and neck region uses a wide range of surgical flaps for defect closure. The methods range from local, mostly myocutaneous flaps, and skin grafts to free microsurgical flaps. Reconstructive surgery must conserve the appearance and mimic the original function. Moreover, the donor-site defect needs to be reduced, with no resulting functional or aesthetic impairment. To achieve these goals, a thin reliable flap that is close to the face and neck region with a good match of the skin texture and a smooth, hairless skin surface is needed. So we used a flap from the shoulder region which provides an optimum skin texture to match the neck and face. This supraclavicular flap is a fasciocutaneous island flap, which has a vascular pedicle extending from the transverse cervical artery with two accompanying veins. Moreover, the tunneling method improves the donor site by reducing scarring. We hereby introduce the anatomic characteristics and effectiveness of this method.
Arteries ; Cicatrix ; Head* ; Humans ; Myocutaneous Flap ; Neck* ; Shoulder ; Skin ; Surgical Flaps ; Tissue Donors ; Transplants ; Veins

Hyperplastic polyps are a benign epithelial proliferation and a common type of colorectal and gastric polyps. Malignant change of hyperplatic polyps is rare. Patients with multiple lesions however, tend to have a high frequency of malignancy. Colorectal polyposis syndromes with gastric polyps include familial adenomatous polyposis, Gardners syndrome, Peutz-Jeghers syndrome, juvenile polyposis and others. But the case of colorectal hyperplastic polyposis with multiple gastric hyperplastic polyps has not been reported until now. A case was recently experienced involving a 32 year old women with both colorectal and gastric hyperplastic polyposis. Multiple hyperplastic polyps were found in the lower part of the body and the antrum of the stomach, rectosigmoid, transverse and ascending colon.
Adenomatous Polyposis Coli ; Adult ; Colon, Ascending ; Female ; Gardner Syndrome ; Humans ; Peutz-Jeghers Syndrome ; Polyps* ; Stomach*

BACKGROUND AND OBJECTIVES: Ex vivo expansion of endothelial cells is important when applying cell therapy to therapeutic angiogenesis in ischemic tissues. Endothelial precursor cells (EPCs) from the umbilical cord blood are one of adult stem cell. In order to establish the culture system for EPCs, we examined the effects of the media and matrix on the differentiation of a subset of mononuclear cells to endothelial cells, and analyzed their endothelial-lineage phenotype. MATERIALS AND METHODS: Mononuclear cells isolated from human umbilical cord blood were cultured in a chamber slide coated with fibronectin or gelatin in a M199 medium supplemented with 10% fetal bovine serum (FBS) (the normal medium) or with 20% FBS and ECGS (the rich medium). Changes in the morphology and the attainment of DiI-ac-LDL uptake ability were examined during a 7 day period. The attached cells were immunostained for CD31, KDR, and vWF. RESULTS: The fibronectin matrix gave rise to more attached cells than the gelatin matrix (about 1.5 fold). The numbers of attached cells were no different between the normal medium and the rich medium at day 3 and 7, and were about 12% of the seeded mononuclear cells. However, the cell size and the numbers of longer spindle-shaped cells increased with the rich medium. Moreover, there was no increase in cellular population, but a 2-3 fold increase in the cellular size between day 3 and 7. About 20-40% of the attached cells acquired the DiI-ac-LDL uptake ability at day 3, whereas more than 85% of the attached cells could be stained with fluorescent DiI-ac-LDL at day 7 (p<0.001). The attached cells after being cultured for 7 days were stained moderately with the antibodies of CD31, or KDR. However, the cells at day 7 were only weakly immunostained with the vWF antibody, whereas more than 90% of cells were strongly stained at day 14. CONCLUSION: These results suggest that a subset of mononuclear cells derived from cord blood cells can give rise to cells with an endothelial cell-like phenotype, in vitro, at high percentages, which could be applied to in vivo vasculogenesis.
Adult Stem Cells ; Antibodies ; Cell Size ; Cell- and Tissue-Based Therapy ; Electrocardiography ; Endothelial Cells ; Endothelium, Vascular ; Fetal Blood* ; Fibronectins ; Gelatin ; Humans ; Phenotype ; Stem Cells ; Umbilical Cord*

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization