Reconstruction of a Large Infected Midline Abdominal Wall Defect Using a Latissimus Dorsi Free Flap

( Han Gyu Cha ),( Eun Key Kim ),( Suk-kyung Hong ) 대한외상학회 2018 大韓外傷學會誌 Vol.31 No.2

Managing large infected midline abdominal defects are clinically challenging and technically demanding. The alloplastic materials, regional flaps, and component separation are usually infeasible because of the size, location, depth, and state of the defects. In these cases, the free flap is the only option with a large well-vascularized tissue that is free to inset regardless of the location. Herein, we report a case of 44-year-old man with a large infected midline abdominal wall defect who was completely treated with a latissimus dorsi myocutaeous free flap followed by negative pressure wound therapy.

Patient-reported outcomes of therapeutic ultrasound on capsular contracture after implant-based breast reconstruction: a preliminary study

Cha Han Gyu,Kang Young Hun,Lee Seo Koo,Park Eun Soo 대한의학레이저학회 2023 MEDICAL LASERS Vol.12 No.4

Background: Capsular contracture after implant-based breast reconstruction (IBR) decreases a patient’s quality of life by causing pain, discomfort, and distortion of the breast. Surgical treatment is the mainstay of capsular contracture management despite the high recurrence rate. This paper reports the preliminary results of therapeutic ultrasound as an alternative treatment option.Methods: Ten patients who underwent an immediate unilateral IBR after a skin- or nipple-sparing mastectomy that resulted in capsular contracture were included in this study. All patients underwent ultrasonic treatment twice a week for 40 minutes every session. The patient-reported outcome was measured using the modified Breast-QTM reconstruction module before and after the 8-week session.Results: Among the five categories in the questionnaire, the average score of tightness/pulling and aching/throbbing feelings improved significantly after the ultrasound treatment without complications.Conclusion: Therapeutic ultrasound was an effective non-surgical treatment in capsular contracture after IBR. Although it is less effective in the esthetical aspects, it helps improve the patient’s quality of life by reducing the subjective symptoms.

Usefulness of Optical Coherence Tomography in the Preoperative Assessment of Nail Deformities

Han Gyu Cha,박은수,남승민 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.3

Secondary nail deformities are often seen at some time after fingertip and nail bed injuries. A proper evaluation of the fingernail enables appropriate diagnosis and treatment, especially in patients who need surgical management. To date, ultrasound and magnetic resonance imaging are the only diagnostic tools that most surgeons use in cases of nail deformities. Herein, we report the case of a patient with a nail deformity who underwent successful correction based on the preoperative use of real-time optical coherence tomography.

Does Fibrin Sealant Reduce Seroma after Immediate Breast Reconstruction Utilizing a Latissimus Dorsi Myocutaneous Flap?

Cha, Han Gyu,Kang, Sang Gue,Shin, Ho Seong,Kang, Moon Seok,Nam, Seung Min Korean Society of Plastic and Reconstructive Surge 2012 Archives of Plastic Surgery Vol.39 No.5

Background The most common complication of latissimus dorsi myocutaneous flap in breast reconstruction is seroma formation in the back. Many clinical studies have shown that fibrin sealant reduces seroma formation. We investigated any statistically significant differences in postoperative drainage and seroma formation when utilizing the fibrin sealant on the site of the latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction after skin-sparing partial mastectomy. Methods A total of 46 patients underwent immediate breast reconstruction utilizing a latissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedure without fibrin sealant and the other 23 were administered the fibrin sealant. All flaps were elevated with manual dissection by the same surgeon and were analyzed to evaluate the potential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U test were used for analyzing the drainage volume according to age, weight of the breast specimen, and body mass index. Results Although not statistically significant, the cumulative drainage fluid volume was higher in the control group until postoperative day 2 (530.1 mL compared to 502.3 mL), but the fibrin sealant group showed more drainage beginning on postoperative day 3. The donor site comparisons showed the fibrin sealant group had more drainage beginning on postoperative day 3 and the drain was removed 1 day earlier in the control group. Conclusions The use of fibrin sealant resulted in no reduction of seroma formation. Because the benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussed with patients before its use as a part of informed consent.

Microsurgical options after the failure of left colon interposition graft in esophagogastric reconstruction

Cha, Han Gyu,Jeong, Hyung Hwa,Kim, Eun Key Korean Cleft Palate-Craniofacial Association 2019 Archives of Craniofacial Surgery Vol.20 No.2

Colon interposition is commonly used for esophageal reconstruction in patients with a previous gastrectomy. However, when colon interposition fails and alternative reconstruction is required, there are few options for reconstructing the long segment from the esophagus to the stomach. Here, we report on cases of esophagogastric reconstruction with limited alternative options after the failure of transverse and left colon interposition. In these cases, reconstruction was performed using two different microvascular methods: double-pedicle jejunal free flap and supercharged ileocolic interposition graft.

Utility of Indocyanine Green Fluorescence Imaging in Wound Assessment

Cha Han Gyu 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.1

The use of indocyanine green fluorescence imaging has become popular in the field of reconstructive surgery as it allows surgeons to confirm flap vascularity and lymphatic flow. Based on its reliability in detecting tissue perfusion, it is now being used to evaluate the status of wounds which helps surgeons make accurate intraoperative and postoperative decisions. This article aims to provide an overview of indocyanine green fluorescence imaging and its current utility in assessment of various wounds.

Does Fibrin Sealant Reduce Seroma after Immediate Breast Reconstruction Utilizing a Latissimus Dorsi Myocutaneous Flap?

Han Gyu Cha,강상규,신호성,Moon Seok Kang,Seung Min Nam 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.5

Background The most common complication of latissimus dorsi myocutaneous flap in breast reconstruction is seroma formation in the back. Many clinical studies have shown that fibrin sealant reduces seroma formation. We investigated any statistically significant differences in postoperative drainage and seroma formation when utilizing the fibrin sealant on the site of the latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction after skin-sparing partial mastectomy. Methods A total of 46 patients underwent immediate breast reconstruction utilizing a latissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedure without fibrin sealant and the other 23 were administered the fibrin sealant. All flaps were elevated with manual dissection by the same surgeon and were analyzed to evaluate the potential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U test were used for analyzing the drainage volume according to age, weight of the breast specimen,and body mass index. Results Although not statistically significant, the cumulative drainage fluid volume was higher in the control group until postoperative day 2 (530.1 mL compared to 502.3 mL), but the fibrin sealant group showed more drainage beginning on postoperative day 3. The donor site comparisons showed the fibrin sealant group had more drainage beginning on postoperative day 3 and the drain was removed 1 day earlier in the control group. Conclusions The use of fibrin sealant resulted in no reduction of seroma formation. Because the benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussed with patients before its use as a part of informed consent.

스트렙토조토신 유발 당뇨병성 신증에서 Retinoid의 항 염증 효과

한상엽 ( Han Sang Yeob ),지이화 ( Ji I Hwa ),소경아 ( So Gyeong A ),한금현 ( Han Geum Hyeon ),강영선 ( Kang Yeong Seon ),차태룡 ( Cha Tae Lyong ),김형규 ( Kim Hyeong Gyu ),한지영 ( Han Ji Yeong ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.3

목적: 당뇨병성 신증의 원인 기전으로 염증반응이 관계한다고 알려진 이후 염증반응을 억제하고자 하는 시도가 있어왔다. 항염증 작용이 있는 retinoid는 면역성 신질환과 당뇨병에서 세포 외 기질 단백의 축적을 줄인다고 보고되었다. 그러나 retinoid가 당뇨병성 신증의 진행에 어떠한 역할을 하는지에 대해서는 연구가 미미한 상태이다. 이에 retinoid가 당뇨병성 신증의 진행과정에 관여하는 염증 작용을 차단할 수 있는지 규명하고자 하였다. 방법: Streptozotocin (STZ)을 쥐에 주사하여 당뇨를 유발시켜 염증 반응을 활성화한 뒤 retinoid를 투여하여 monocyte chemoattractant peptide-1 (MCP-1) 발현을 측정하여 항염증 효과를 평가하였다. 결과: 당뇨가 유발된 쥐들에서 군간 혈당 차이는 없었다. 당뇨 발생 초기 (2일)에 차이가 없던 24시간 요 단백양이 4주 후에는 증가되었고, 당뇨군 내에서는 retinoid를 투여한 군에서 투여하지 않은 군에 비해 단백뇨 양이 감소되는 경향을 보였다. 소변에서 발현된 MCP-1 단백양은 비당뇨군에 비해 당뇨군에서 초기부터 증가하는 경향을 보이다 4주 후에는 의미있게 증가하였다. 당뇨군에서 증가한 소변내 MCP-1 단백 발현이 retinoid를 투여한 경우 약 제를 투여하지 않은 군에 비해 감소하는 경향을 보였다. 신장 피질에서 추출한 RNA에서 MCP-1의 발현을 측정한 결과 비당뇨군에 비해 당뇨군에서 의미있게 증가되었으나 retinoid 투여효과는 관찰되지 않았다. MCP-1에 대한 면역 조직 화학 염색 결과 2일째부터 MCP-1 발현은 당뇨군에서 대조군에 비해 증가되어, 4주 후에는 의미 있게 차이가 났으며, retinoid를 투여한 경우 MCP-1의 발현은 뚜렷이 감소되었다. 결론: STZ 유발 당뇨쥐에서 MCP-1 단백 발현이 증가되는 것을 인하였고, 증가된 MCP-1 발현이 retinoid를 투여하는 경우 감소하는 것을 확인하였다. 이를 통해 당뇨병성 신증의 진행과정 중 retinoid가 염증반응을 차단할 수 있을 것으로 예상하였다. Background : An inflammatory mechanism has been suggested to contribute to the progression of diabetic nephropathy. Although retinoid, a known anti-inflammatory agent. has been reported to be beneficial in some experimental renal diseases, it has not been shown whether it prevents disease progression in diabetic nephrogathy. Therefore, we investigated whether all-trans retinoic acid inhibits inflammatory changes and improves renal function during the early stages of diabetic nephropathy in streptozotocin-induced diabetic rats. Methods : We evaluated anti-inflammatory effect of retinoid on streptozotocin-induced diabetic nephropathy. Anti-inflammatory effect was determined by the expression of monocyte chemoattractant peptide-1 (MCP-1). Results : Urinary protein excretion was significantly higher in diabetic rats at four weeks after the induction of diabetes mellitus compared with controls, and proteinuria in the group with retinoic acid treatment was decreased (1.25±0.69 vs. 0.78k0.72 mg/mg Cr, p=0.056). Urinary excretion of MCP-1 was rapidly increased at two days after induction of diabetes mellitus in diabetic rats, and further increased until four weeks of age compared with control rats. Retinoic acid treatment suppressed to 30% reduction of the urinary level of MCP-1 compared with vehicle treated diabetic rats (l19.3 ± 74.2 vs. 78.1±62.7 pg/mg Cr, p=0.078). Immunohistochemistry revealed a significant increase in staining for MCP -1 protein in the diabetic kidney, and retinoic acid treatment significantly suppressed intrarenal MCP-1 protein synthesis. Conclusion : Retinoic acid suppressed proteinuria and inflammatory changes in diabetic rats. These results suggest that retinoic acid may have an anti inflammatory effect in diabetic nephropathy. (Korean J Nephrol 2004;23(3):377-384)

Metabolic control of primed human pluripotent stem cell fate and function by the miR-200c–SIRT2 axis

Cha, Young,Han, Min-Joon,Cha, Hyuk-Jin,Zoldan, Janet,Burkart, Alison,Jung, Jin Hyuk,Jang, Yongwoo,Kim, Chun-Hyung,Jeong, Ho-Chang,Kim, Byung-Gyu,Langer, Robert,Kahn, C. Ronald,Guarente, Leonard,Kim, K Nature Publishing Group 2017 NATURE CELL BIOLOGY Vol. No.

<P>A hallmark of cancer cells is the metabolic switch from oxidative phosphorylation (OXPHOS) to glycolysis, a phenomenon referred to as the 'Warburg effect', which is also observed in primed human pluripotent stem cells (hPSCs). Here, we report that downregulation of SIRT2 and upregulation of SIRT1 is a molecular signature of primed hPSCs and that SIRT2 critically regulates metabolic reprogramming during induced pluripotency by targeting glycolytic enzymes including aldolase, glyceraldehyde-3-phosphate dehydrogenase, phosphoglycerate kinase, and enolase. Remarkably, knockdown of SIRT2 in human fibroblasts resulted in significantly decreased OXPHOS and increased glycolysis. In addition, we found that miR-200c-5p specifically targets SIRT2, downregulating its expression. Furthermore, SIRT2 overexpression in hPSCs significantly affected energy metabolism, altering stem cell functions such as pluripotent differentiation properties. Taken together, our results identify the miR-200c-SIRT2 axis as a key regulator of metabolic reprogramming (Warburg-like effect), via regulation of glycolytic enzymes, during human induced pluripotency and pluripotent stem cell function.</P>

First Report of Take-All on Turfgrass Caused by Gaeumannomyces graminis Var. Graminis in Korea

Cha, Jae-Yul,Lee, Jung-Han,Kim, Jeong-Ho,Shim, Gyu-Yul,Bae, Eun-Ji,Kwak, Youn-Sig Turfgrass Society of Korea 2012 한국잔디학회지 Vol.13 No.2