Nerve Regeneration Using a Vein Graft Conduit filled with Hyaluronic Acid in a Rat Model

PURPOSE: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. METHODS: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups RESULTS: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was -52.5+/-8.2 in group I, -68.1+/-4 in group II, -55.3+/-7.9 in group III. In electrophysiological study, NCV(nerve conduction velocity) was 26.71+/-3.11m/s in group I, 17.94+/-4.35 m/s in group II, 25.69+/-2.81m/s in group III. The functional recovery in group I and III was superior to that the group II statistically(p<0.05) Under electromicroscopic study, the number of the myelinated axons were 1419.1+/-240 in group I, 921.7+/-176.8 in group II, 1322.2+/-318 in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). CONCLUSION: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

Nerve Regeneration Using a Vein Graft Conduit filled with Hyaluronic Acid in a Rat Model

PURPOSE: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. METHODS: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups RESULTS: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was -52.5+/-8.2 in group I, -68.1+/-4 in group II, -55.3+/-7.9 in group III. In electrophysiological study, NCV(nerve conduction velocity) was 26.71+/-3.11m/s in group I, 17.94+/-4.35 m/s in group II, 25.69+/-2.81m/s in group III. The functional recovery in group I and III was superior to that the group II statistically(p<0.05) Under electromicroscopic study, the number of the myelinated axons were 1419.1+/-240 in group I, 921.7+/-176.8 in group II, 1322.2+/-318 in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). CONCLUSION: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

Seven Cases of Cutaneous Angiosarcoma of the Scalp of the Aged / 대한피부과학회지

Cutaneous angiosarcoma is a rare, aggressive vascular malignancy with a grave prognosis. It usually arises in the scalp or face as a locally-advanced patch, plaque or tumor at presentation and most often affects males and the elderly. Histopathologically, well-differentiated angiosarcomas are composed of well- or ill-formed vascular channels, often lined by flattened atypical endothelial cells and are distinguished from benign counterparts by their so-called "collagen dissection pattern" and anastomosing architecture. Varied differentiation may be observed even in the same tumor. Epithelioid angiosarcoma is a rare variant of poorly-differentiated angiosarcoma. The patients were seven cases of angiosarcomas including an epithelioid variant. They were six males and one female with an age range between 65~84 years (avg. 74 years). Lesions resembled seborrheic dermatitis, erysipelas or "spreading bruise" that varied from blue to red in color and from papule to mass in size. They revealed satellite lesions far from the main lesion in some cases. Skin biopsies were performed for all patients and histopathologic features were compatible with angiosarcoma and epithelioid angiosarcoma. We herein report seven angiosarcomas of diverse clinical features because their early detection and precise differential diagnosis should be mandatory for effective management.

Clinical Experiences of Face Lift: A Marginal Tragal Incision and Two Point Anchor

There is one problematic part of the facialplasty procedure that has been addressed with relative infrequency in the plastic surgery literature. Hypertrophic scar, deformed tragus and "pixie ear" deformity, the problems associated with the design and closure of the periauricular incisions, are still recognized. Prevention of these undesirable results of facialplasty is the surgical challenge about which this article is concerned. In facelift, pretragal incision leaves long scar formation on preauricular area and retrotragal incision occasionally makes the unnatural tragus. Since the marginal tragal incision consists of several short segments, it can prevent tragal deformity caused by scar contracture and preserve shape of the tragus. Putting 2 anchoring key sutures on just above the ear and at the mastoid area minimizes the tension on the incision line and minimizes postoperative ear deformity. We experienced 42 face lifting procedures in patients with aging face during the last 6 years(from Dec 1999 to May. 2005). Complications were hematoma in four cases(9.5%) and focal wound dehiscence in two cases(4.8%). The patients with the complications completely recovered 3 months later.