Application of Indocyanine green in visual treatment of oral cancer / 口腔疾病防治

@#Indocyanine green (ICG) is a fluorescence indicator characterized by low trauma, a long effect time, low cytotoxicity, and high imaging resolution. It has been widely used in biomedical applications. However, ICG is not widely used in the treatment of oral cancer. This article reviews the application of ICG in the diagnosis and treatment of oral cancer. The results of a literature review showed that in the diagnosis and treatment of oral cancer, ICG mainly plays a role through the enhanced permeability and retention (EPR) effect of fluorescent substances and in coupling with various tumor-specific antibodies. For tumor visualization, ICG can focus on the primary tumor and lymph node metastasis by coupling the specific tumor antibodies and the EPR effect to guide the complete resection of the primary tumor and the determination of neck lymphadenectomy. In the reconstruction of the oral, head and neck regions, semi-quantitative measurement of ICG fluorescence intensity can be used to design a guide for a vascularized flap during the operation, for early detection of flap crisis after the operation, and to guide clinical flap exploration opportunities. In nonsurgical treatments of oral cancer, such as photothermal therapy and photodynamic therapy, ICG, as an important component of photosensitive nanomaterials, has attracted the attention of many scholars. ICG has good application prospects in the resection, reconstruction, visualization and nonsurgical treatment of oral cancer.

Reconstruction of ankle using free vascularized flap from amputated hand: A case report / 대한정형외과학회잡지

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.

Morphologic Study on a Vascularized Composite Flap for Tracheal Reconstruction in Rabbit: I. Light Microsopic Study / 대한이비인후과학회지

Successful regeneration of a cartilage framework using perichondrium has been reported by several authors but there are some arguments surrounding mucosal regeneration. Some authors report that regeneration of mucosa is completed by ingrowth from neighboring tissue but others insist that it occurs via metaplasia from the squamous epithelium. This study was designed to investigate the differences in regeneration between nonvascularized and vascularized flaps. A 5 X 15mm sized vascularized composite flap composed of vascularized perichondrium pedicled on the central auricular artery and free buccal mucosa which was harvested from the oral cavity and sutured on the vascularized perichondrium was fabricated in a rabbit ear. It was transferred to a pre-created 4 X 12mm tracheal defect. A morphologic study was carried out to determine the outcome of the grafted mucosa at regular intervals under light microscopy after H and E staining. A nonvascularized perichondrial-mucosal composite flap with the same dimension was transferred in the control group. The results are as follows;1) The control group showed necrosis of the grafted mucosa and defective area was covered by ingrowth of the neighboring normal mucosa. The periphery of the defective area regenerated earlier than the central area and immature epithelia were still found 6 weeks after the graft. Regeneration of cilia was rather inconsistently observed 8 weeks after the transfer. 2) In the experimental group, the grafted mucosa survived on the vascularized perichondrium which was thought to act as a vascularizing bed. Two weeks after reconstruction, the covering epithelium appeared almost as normal as the tracheal columnar epithelium. At 4 weeks, the regenerated mucosa could hardly be distinguished from the normal mucosa. Regeneration of cilia was consistent at 6 weeks in the experimental group. Mucosal regeneration in the experimental group was superior to the control group in terms of degree and quality. Mucosal coverage of the control group occurred by ingrowth from the neighboring mucosa. In the experimental group, survival of the grafted mucosa relied upon revascularization through the vascular pedicle. It can be conceived that metaplasia of the grafted mucosa occurs in a vascularized composite flap transferred group. In conclusion, maintenance of vascularization is essential to successful regeneration of grafted mucosa with good quality.