It has been generally believed that the continuous flow of blood characterised by arterial inflow and venous outflow is essential for the survival of flaps. Since Baek et al.(1985) demonstrated the survival of a flap based on only a single vein without arterial inflow, there have been a lot of reports of successful skin flaps that depend on only venous blood flow. The location of pedicle is one of the important factors on the survival of flaps, but there have not been an effective study on the survival rates of venous island flaps according to their location of pedicles. In this study, we compared the survival rates of proximally based venous island flaps with those of distally based ones and attempted to decrease the difference, if any, in the survival rates between them. Distally or proximally based 4x3 cmvenous island flap, whose pedicle was a marginal branch of central vein, was elevated from the auricular cartilage of New Zealand white rabbit. IN the half of 20 rabbits, superoxide dismutase (SOD, 20,000 U/kg) was injected intravenously 30 minutes and 60 minutes after the flap elevation. On the 7th postoperative day, survival areas of the flaps were measured by image analysis system and the vascular network with the flaps were examined by micro fil cast. 40 flaps were divided as follows: proximally based venous flaps, distally based venous flaps, SOD treated proximally based venous flaps, SOD ttreated distally based venous flaps. The results were as follow: 1. The survival rate(79.39+/-9.24%) of the proximally based venous flaps were significantly higher than those(60.79+/-14.10%) of the distally based ones (p< 0.01). 2. SOD improved survival of the flap significantly (p< 0.05), and there was no statistical difference in the survival rates between proximally based venous flaps and SOD treated distally based venous flaps (p = 0.1785). 3. Revascularization was actively developed in the proximally based venous flaps and those flaps treated with SOD, but was minimal in the distally based venous flaps. These results suggested that the vascular pedicle would rather be located proximally than distally in designing the venous island flaps and that SOD treatment may be effective for the enhancement of survival of venous island flaps, especially in distally based ones.
Ear Cartilage ; New Zealand ; Rabbits ; Skin ; Superoxide Dismutase* ; Superoxides* ; Surgical Flaps ; Survival Rate ; Veins

Island flaps have been widely used for the management of soft tissue defects in reconstructive surgery. The necrosis of the flap has been a catastrophe in clinical fields. It is well known that revascularization to the flap after ligation of its pedicle comes from the recipient bed and flap margins. The authors investigated the effects of the ischemic recipient bed on island flap survival after the ligation of its pedicle in the rats. One hundred and thirty inferior epigastric island flaps were divided into three groups (Group I, Group II, and Group III) according to the degree (0%,20%, and 60%) of interruption of contact of flap with the recipient bed, respectively. In Group I,the vascular pedicles were ligated before and on the 0, 2nd, 3rd, 4th and 5th days after flap elevation, and in Group II & III, the vascular pedicles were ligated on the 2nd, 3rd, 4th and 5th days after flap elevation. Flap survival was assessed on the 3rd day after pedicle ligation. Microangiographic studies were also performed on the 3rd day after pedicle ligation to study revascularization within the flap and the change of blood vessels around the flap margins. The results were as follows: 1. Flap survival was increased significantly in the flaps with pedicle ligation on the 4th and 5th postoperative days compared to those at the 2nd and 3rd postoperative days. 2. From the 3rd postoperative day, flap survival was not influenced significantly by the degree of limited bed contact and the date of pedicle ligation. 3. In spite of limited bed contact, the flap will likely survive with abundant revascularization from the flap margins. In conclusion, the flaps with limited bed contact were revascularized significantly from the flap margin by the 3rd postoperative day.
Animals ; Blood Vessels ; Ligation ; Necrosis ; Rats ; Surgical Flaps

No abstract available.
Granuloma* ; Subphrenic Abscess*

No abstract available.

No abstract available.
Chickens* ; Plasminogen* ; Tendons*

No abstract available.
Dislocations* ; Hip* ; Osteotomy*

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Necrosis*

No abstract available.

The antiphospholipid antibody syndrome is an acquired multisystemic disorder characterized by persistent elevated antiphospholipid antibodies and/or hypercoagulation in veins or arteries, or both. The clinical manifestations of the antiphospholipid antibody syodrome are recurrent thrombosis, fetal loss, thrcenbocytopenia, and various cutaneous lesions. Skin lesions are the first sign of this syndrome in 41% of patients and systemic thrombosis develops in 40% of them. Livedo reticularis is the most common cutaneous finding of the antiphosphotipid antibody syndrome. Although vasculitis has not been frequently noted in antiphospholipid antibody syndrome, some vasculitis such as polyarteritis nodosa, giant cell arteritis, and other nonspecific vasculitides have been found in association with antiphospholipid antibody syndrome. We present a male patient with typical manifestations of leukocytoclastic vasculitis with deep vein thrombosis and positive antiphospholipid antibodies. It suggests that a case of antiphospholipid antibody syndorme was accompanied with cutaneous leukocytoclastic vasculitis.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Arteries ; Giant Cell Arteritis ; Humans ; Livedo Reticularis ; Male ; Polyarteritis Nodosa ; Skin ; Thrombosis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

Psychiatric problems in cabin and cockpit crews are one of the main causes of their medical disqualification. Fear of flying is the primary psychiatric problem, which is a clinical manifestation of diverse anxiety disorders such as specific phobia, post-traumatic stress disorder and somatoform disorder. They are under-diagnosed and under-treated due to the social stigma and crews' avoidance of notice. We should pay attention to their psychiatric problems. Especially the prevention and treatment program for crews' psychiatric disorders should be established.
Anxiety Disorders ; Diptera ; Phobic Disorders ; Social Stigma ; Somatoform Disorders ; Stress Disorders, Post-Traumatic