PURPOSE: We measured linear distances, angles and inclinations on the cast models of the noses, and compared these indirect measurements with the direct measurements obtained from the nose in order to validate the accuracy of the indirect anthropometry using the cast model. METHODS: Subjects were 50 males and 50 females, medical students in twenties(mean 27.1 years). Cast models were made from the alginate impression material and the plaster. In direct anthropometry, 16 linear, 7 angular, and 2 inclination measurements between 11 landmarks on the nose were obtained using sliding caliper, spreading caliper, and fabric tape measure. At the same time, the same measurements were obtained from the cast models of the same people. Total 25 measurements were compared, and tested by the independent t-test of SPSS. RESULTS: The standard values of Korean nose in twenties were obtained. 24 measurements except the columellar labial angle were not statistically different between the indirect anthropometry and the direct anthropometry. CONCLUSION: Indirect anthropometry on the cast model of the nose revealed no significant difference from the anthropometric measurement statistically, accounting for 24 in 25 measurements(96%). There are two possible reasons that caused the difference of columellar labial angle between direct and indirect anthropometry. First, the columellar labial angle could be decreased by protrusion of the lips which resulted from contracting mouth in which an drinking straw had been applied on the mouth corner for patients' respiration during making cast model. Second, it is generally known that the columellar labial angle could be measured larger when soft tissues were pressed by protractor in direct anthropometry. Using a drinking straw with greater diameter, and scheming respiration through the nostrils that patients don't feel discomfort, the more accurate data would be obtained from the indirect anthropometry using the cast models of the noses.
Accounting ; Alginates ; Anthropometry ; Contracts ; Drinking ; Female ; Glucuronic Acid ; Hexuronic Acids ; Humans ; Lip ; Male ; Mouth ; Nose ; Respiration ; Students, Medical

PURPOSE: Advanced techniques now make it possible to remove considerable amounts of subcutaneous adipose tissue more safely with minimum blood loss. However, few have analyzed the metabolic consequences of liposuction. The purpose of this study was to identify the early effects of the surgical removal of subcutaneous fat on metabolic changes in patients who have undergone liposuction. METHODS: Nineteen patients were evaluated from June 2005 to December 2005. Preoperative body weight, serums levels of lipids, apolipoprotein A1, dehydroepiandrosterone(DHEA), uric acid, insulin, and glucose were evaluated. Insulin resistance was determined using the homeostasis model assessment of insulin resistance (HOMA-IR), which is based on fasting glucose and insulin concentrations. All of these data were remeasured in 1 and 4 weeks postoperatively. Tumescent fluid was infiltrated using the superwet technique. The liposuction device used was a Liposlim(R) power-assisted unit. RESULTS: Average volumes of infiltrate and aspirate were 3,268mL and 2,892mL, respectively. Results in 1 week postoperatively demonstrated a significant difference in high-density lipoprotein(HDL) cholesterol, apolipoprotein A1, insulin, and HOMA-IR levels. However, all values were within normal limits and returned to baseline in 4 weeks postoperatively. CONCLUSION: This study provides little to support the presumed therapeutic effect of liposuction. And, it is unclear whether liposuction can prevent or be used to treat the metabolic complications of obesity. However, the results of the present study lead us to believe that liposuction is a metabolically safe procedure.
Apolipoprotein A-I ; Body Weight ; Cholesterol ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Lipectomy ; Obesity ; Subcutaneous Fat ; Uric Acid

PURPOSE: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match. METHODS: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness). RESULTS: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins. CONCLUSION: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.
Eyelids ; Forehead ; Hand ; Humans ; Nose ; Skin ; Tissue Donors ; Transplants

PURPOSE: The pedicle of transverse rectus abdominis myocutaneous(TRAM) flap and deep inferior epigastric arterial perforator flap is deep inferior epigastic artery (DIEA) and accurate anatomic knowledge about perforator of DIEA is very important for the elevation of these flap. The authors investigated a detailed vascular network of perforator of DIEA in Koreans. METHODS: 24 fresh cadavers were studied. Among them, 15 were examined based on the plain X-ray examination for the distribution and location of perforator of DIEA. And 9 fresh cadavers were examined based on the 3-dimensional computed tomography(CT) study for the distance between ending point of perforator of DIEA and mother artery, the distance between most medial mother artery and midline, the distance between most lateral mother artery and midline, and the running type of perforators of DIEA. RESULTS: Based on the plain X-ray examination, suitable(external diameter> or =0.5mm) perforators of DIEA are located between the level of umbilicus and 8cm below it. Based on the 3D-CT study, average distance between the ending point of perforator of DIEA and the mother artery is 30.26mm on the left, 28.62mm on the right, respectively. The average distance between most medial mother artery and midline is 17.13mm on the left, 15.76mm on the right, respectively. The average distance between most lateral mother artery and midline is 56.31mm on the left, 50.90mm on the right, respectively. The main running course of suitable perforators of DIEA is type a, which is a direct musculocutaneous perforator vessel from main vascular axis passing outward to join the subdermal plexus, directly. CONCLUSION:3-dimensional computed tomography study as well as plain X-ray examination provided more accurate and detail informations about perforators of DIEA in Koreans. These informations will help us understand the detailed vascular anatomy and operation with ease and safe in the lower abdomen of Koreans.
Abdomen ; Arteries ; Axis, Cervical Vertebra ; Cadaver ; Epigastric Arteries ; Ethylamines ; Glycosaminoglycans ; Humans ; Mothers ; Perforator Flap ; Rectus Abdominis ; Running ; Umbilicus

PURPOSE: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. METHODS: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap (12x12cm) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. RESULTS: On average 2.3+/-1.1 perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were 11.9+/-3.5cm and 3.1+/-0.8mm on average. CONCLUSION: This study will be helpful for the success in anterolateral thigh free flap.
Anatomy, Regional ; Arteries ; Cadaver ; Femoral Artery ; Free Tissue Flaps ; Muscles ; Patella ; Quadriceps Muscle ; Spine ; Thigh

PURPOSE: Human adipose tissue-derived mesenchymal stem cells(hATSCs) can be differentiated into multiple mesenchymal lineages, including bone, cartilage, and muscle. And growth hormone play important roles in the normal growth and development of the CNS. In this study, we explored whether the transplanted hATSCs and growth hormones could improve functional recoveries from rats with contusive spinal cord injury. METHODS: We divided 30 female rats, which were subjected to a weight driven implant spinal cord injury, into 3 groups with 10 rats each; Group A as a control group, group B with hATSCs transplantation on injured region, and group C with hATSCs transplantation and GH administration for 7 days. Then, we researched their neurologic functional recoveries before and 2, 4, and 8 weeks after transplantation using Basso-Beattie-Bresnahan (BBB) locomotor rating scale. And we checked Y- chromosome positive cells by FISH(Fluorescent in situ hybridization) to identify the survival of transplanted mesenchymal stem cells. RESULTS: After 4 weeks of transplantation, the group B and group C showed significant improvement of neurologic function on BBB locomotor rating scale in comparison with the group A(Group A: 13.1+/-0.58, Group B: 14.6+/-0.69, Group C: 14.9+/-0.56). Moreover, the group C displayed meaningful recovery of neurologic function after 8 weeks in comparison with group B (Group B: 15.7+/-0.63, Group C: 16.5+/-1.14). The group A, the control one, improved for 5 weeks after injury, and had no more recovery. On the other hand, Group B and C showed the improvement of neurologic function continuously for 9 weeks after injury. CONCLUSION: In this study, we found out that hATSCs transplantation have an effect on neurologic functional recovery of spinal cord injured rat and GH injection seems to bring the synergistic results on this good tendency.
Adipose Tissue ; Animals ; Cartilage ; Female ; Growth and Development ; Growth Hormone ; Hand ; Humans ; Mesenchymal Stromal Cells ; Muscles ; Rats ; Spinal Cord ; Spinal Cord Injuries ; Transplants

PURPOSE: Since the report of artificial dermis manufacturing method using collagen by Yannas in 1980, collagen has been effectively used as dermal substitute with its merits such as, lower antigeneicity, controllable biodegradation rate, and minimal inflammatory cytotoxic properties in the dermal tissue engineering field. However, weak mechanical durability was the main drawback of collagen dermal substitute. To improve its stability, mechanical or chemical cross-linking was used. Despite of such process, its clinical use was restricted due to weak durability. To improve the durability of collagen matrix, we designed elastin-incorporated collagen matrix and compared its durability with conventional collagen matrix. METHODS: 15mm diameter with 4mm thick collagen dermal matrix was made according to Yannas protocol by mixing 0.5% bovine collagen and chondroitin-6- sulfate followed by degassing, freeze drying, dehydrodermal cross-linking and chemical cross-linking procedure. In elastin incorporated collagen matrix, same procedure was performed by mixing elastin to previous collagen matrix in 4:1 ratio(collagen 80% elastin 20%). In comparison of the two dermal matrix in vitro tests, matrix contracture rate, strain, tensile strength, was measured and stiffness was calculated from comparative analysis. RESULTS: In terms of matrix contracture, the elastin- incorperated added collagen dermis matrix showed 1.2 times more contraction compared to conventional collagen matrix. However, tensile strength showed 1.6 times and stiffness showed 1.6 times increase in elastin- incorporated matrix. CONCLUSION: Elastin incorperated collagen matrix manufactured by our team showed increased durability due to improvement in tensile strength and stiffness compared to previous collagen matrix(Integra(R)).
Collagen ; Contracts ; Contracture ; Dermis ; Elastin ; Freeze Drying ; Sprains and Strains ; Tensile Strength ; Tissue Engineering

PURPOSE: In tissue engineering, it is important that the scaffolds have high affinity with cells for making efficient use of cells. The authors studied the binding affinity of human adipose stem cells(ASCs) to micronized acellular dermal matrix(alloderm) using biotin and avidin linkages. METHODS: Human ASCs were harvested from adipose tissue obtained by abdominoplasty. ASCs(1x10(4), 5x10(4), 1x10(5), 5x10(5), 1x10(6), 5x10(6) cells) were attached to micronized alloderm(1mg) in three groups; 1) control group in which no ASCs and alloderm was treated; 2) serum group in which alloderm was exposed to fetal bovine serum; and 3) biotin group in which biotinylated cells were attached to biotinylated alloderm. The binding affinities were determined 1 day after making ASC-alloderm complexes. The proliferation rates were determined by XTT assays in 4, 7, 14, and 21 days and scanning electron microscopic examination was performed in 7 and 21 days after culture of ASC-alloderm complexes. RESULTS: The binding affinities of the biotin group were significantly increased in all cell concentrations. Maximum binding affinity was observed at 5x10(4)/mg of micronized dermal matrix in biotin group. The viabilities were lowest in biotin group in contrast to binding affinity, but the difference was not significant. SEM showed well attachment of cells to micronized dermal matrix in all groups. CONCLUSION: The use of avidin/biotin facilitated human ASCs attaching to micronized acellular dermal matrix. This attachment would not disturb adipose stem cells viabilities. The present study suggests that avidin/ biotin can be used as making efficient use of cells in adipose tissue engineering.
Abdominoplasty ; Acellular Dermis ; Adipose Tissue ; Avidin ; Biotin ; Collagen ; Electrons ; Humans ; Mesenchymal Stromal Cells ; Stem Cells ; Tissue Engineering

Spontaneous venous thrombosis developing in the internal jugular vein is very unusual. The common causes usually include intravenous drug abuse, jugular vein catheterization, neck dissection, a hypercoagulable state associated with malignancies, neck injury or ovarian overstimulation syndrome. A 30-year-old woman with no remarkable past medical history visited our outpatient office due to neck swelling with pain. She underwent CT scan, Doppler sonogram and fine needle aspiration biopsy. We could confirm metastatic lymphadenopathy and internal jugular vein thrombosis. We present here the case of internal jugular vein thrombosis associated with metastatic malignancy.
Adult ; Biopsy ; Biopsy, Fine-Needle ; Catheterization ; Catheters ; Female ; Humans ; Jugular Veins ; Lymphatic Diseases ; Neck ; Neck Dissection ; Neck Injuries ; Outpatients ; Substance Abuse, Intravenous ; Thrombosis ; Venous Thrombosis

There are many causes of extrahepatic biliary obstruction. The most common causes are gallstones and malignant or benign strictures. Web of the common bile duct is a rare disease, and it may produce obstructive jaundice. On cholangiography, a common bile duct web typically appears as a shelf--like radiolucent ring. It is frequently associated with bile duct stone, and it is occasionally related to bile duct trauma or primary sclerosing cholangitis. We report here on a case of a web of the common bile duct without choledocholithiasis in a 27-year-old man. The patient was treated by Roux-en-Y choledochojejunostomy above the level of the web.
Adult ; Bile Ducts ; Cholangiography ; Cholangitis, Sclerosing ; Choledocholithiasis ; Choledochostomy ; Common Bile Duct ; Constriction, Pathologic ; Gallstones ; Humans ; Jaundice, Obstructive ; Rare Diseases