Biomedical subjects

S D Lin

Publications and source records attributed to S D Lin.

At least 37 records · Page 2Linked to original sources

PubMed2000

Extensor digitorum brevis rotational muscle flap for lower leg and ankle coverage.

BACKGROUND: Soft tissue reconstruction around the ankle has been a challenging problem. This article reports our experience using the extensor digitorum brevis muscle flap; some technical variations are discussed. METHODS: The extensor digitorum brevis muscle flap is vascularized by the well-defined lateral tarsal artery, a branch of the dorsalis pedis artery originating at the level of the inferior extensor retinaculum. This flap was used for coverage of soft tissue defects in the lower leg and the ankle in 10 patients with various injuries. RESULTS: All flaps survived completely. Complications included delayed healing of donor skin in two cases. Flap elevation was possible even in the traumatized donor foot. CONCLUSION: The advantages of this flap include constant and reliable blood supply, easy and rapid flap dissection, adequate bulk, and one-stage procedure. However, disadvantages include the small size of the flap and the sacrifice of the dorsalis pedis artery.

Adolescent↗

PubMed2000

Continuous intra-arterial infusion therapy in hydrofluoric acid burns.

To determine the effect of continuous intra-arterial calcium gluconate infusion therapy on patients suffering from hydrofluoric acid dermal burns of the digits, clinical treatment was performed prospectively on 10 patients from January 1997 to December 1998 at the burn care unit of Kaohsiung Medical University Hospital. An arterial catheter was inserted transcutaneously through the radial artery of the involved hand. After confirmation of the proper position of the catheter, calcium gluconate was infused continuously with an ambulatory infusion pump. Rapid pain relief was achieved immediately after infusion. The rate of infusion was then tapered down gradually, and treatment was completed with no major therapeutic complication. All injured digits of these 10 patients were successfully salvaged with good cosmetic appearance and complete functional preservation. Compared with other conventional therapies, continuous intra-arterial calcium gluconate infusion therapy proved to be a safe, rapid, simple, portable, and effective method for treating hydrofluoric acid dermal burns.

Adult↗

PubMed1999

The use of composite acellular allodermis-ultrathin autograft on joint area in major burn patients--one year follow-up.

Scar contracture is a major long-term sequelae of meshed split-thickness skin grafts in the case of full-thickness burn injuries, and especially in joint areas. Severe contracture around joints may lead to loss of mobility. The thickness of the dermis in the autograft plays a major role in the functional and cosmetic outcomes of the third degree burn. How to replace lost dermis is a major problem in skin restoration following severe burns. The human allograft skin (AlloDerm) is an acellular dermal matrix with normal collagen bundling organization and intact basement membrane complex. We present 12 cases of clinical application of a composite grafting technique in which the allogeneic skin (AlloDerm) provided source of dermis, and an ultrathin autograft (0.004-0.006 inch in thickness) provided epidermis. In these patients, The composite grafts were applied to full-thickness burn wounds over various articular skin surfaces. The average skin graft take rate was 91.5%. These ultrathin autografts allow the donor sites to heal faster. The mean time of donor site reepithelization was 6 days. All patients had a nearly normal range of joint motion (average 95% of normal) after one year's follow up. Wound assessment over time has shown supple skin that has been resistant to trauma and infection. The cosmetic results were judged to be fair to good by surgeons and patients after one year's follow up.

Adult↗

PubMed1998

Apolipoprotein(a) yeast artificial chromosome transgenic rabbits. Lipoprotein(a) assembly with human and rabbit apolipoprotein B.

The in vivo analysis of lipoprotein(a) (Lp(a)), an independent atherosclerosis risk factor in humans, has been limited in part by its restricted distribution among mammals. Although transgenic mice have been created containing Lp(a), the relatively small size of the mouse has precluded some studies. To examine the properties of this molecule in a significantly larger mammal, we have used a 270-kilobase yeast artificial chromosome clone containing the human apolipoprotein(a) (apo(a)) gene and a 90-kilobase P1 phagemid clone containing the human apolipoprotein B (apoB) gene to create transgenic rabbits that express either or both transgenes. Expression of both transgenes was tissue specific and localized predominantly to the liver. Average apolipoprotein plasma levels in the rabbits were 2.5 mg/dl for apo(a) and 17.6 mg/dl for human apoB. In contrast to observations in apo(a) transgenic mice, we found that apo(a) plasma levels in the rabbits were stable throughout sexual maturity. Also, apo(a) formed a covalent association with the endogenous rabbit apoB albeit with a lower efficiency than its association with human apoB. The analysis of Lp(a) transgenic rabbits has provided new insights into apo(a) expression and Lp(a) assembly. In addition, these transgenic rabbits potentially will provide an improved experimental model for the in vivo analysis of Lp(a) and its role in promoting atherosclerosis and restenosis.

Amino Acid Sequence↗

PubMed1998

Differential expression of protein kinases in cultured primary neurons derived from the cerebral cortex, hippocampus, and sympathetic ganglia.

Protein kinases play pivotal roles in the development of the nervous system. They are involved in almost every stage of neuronal development, from initial proliferation and differentiation of progenitor cells to pathfinding of neurites and formation of synapses. Activation of protein kinases is also critical for neuronal cell survival. To gain further insights into kinases in neural development, we studied the expression patterns of protein kinases in three cultured primary neurons by degenerate primer-based reverse transcription-polymerase chain reaction (PCR) and DNA sequencing, taking advantage of all known kinases containing a conserved catalytic domain. Our data demonstrated that the expression patterns of kinases in various cultured neurons are not only different from those of non-neural tissues, but also distinct among neurons derived from discrete origins. For example, FGF receptor 1 is predominantly expressed in hippocampal neurons. As this approach may be biased during PCR and cloning steps, an RNase protection assay was employed to verify the expression levels of six kinases in cultured neurons. Results from the RNase protection assay did generally confirm those obtained by the PCR-based method. However, quantitative nature of the latter was dependent on numbers of clones analyzed, and discrepancy of expression levels of kinases detected by the two methods was sometimes observed.

Animals↗

PubMed1998

Endoscopically-assisted adipofascial flap harvest for soft tissue defects of the lower leg.

Five cases of soft tissue defect of the lower leg were reconstructed successfully with the distally based medial adipofascial flap which was harvested with endoscopically-assisted surgery. The size of these flaps ranged from 4.0 x 7.0 cm to 5.0 x 15.0 cm in size. All the flaps had good perfusion and uneventful course postoperatively. The donor site skin was intact except for an additional access-scar 2.5 cm in length. The donor site morbidity of the adipofascial flap was further minimised in this series.

Accidents, Traffic↗

PubMed1998

The distally based lateral adipofascial flap.

The distally based lateral adipofascial flap can be based either on the lowermost perforator or the anterior perforating branch of the peroneal artery avoiding sacrifice of the main peroneal artery. It has been used successfully to resurface soft tissue defects either on the lateral or medial aspect of the lower third of the leg in 13 cases. The size of these flaps varied from 2.0 cm x 5.0 cm to 4.5 cm x 15.0 cm in size. These cases had minimal donor site morbidity and had positive aesthetic results. The advantages were: 1. Choice of either the lowermost perforator or the anterior perforating branch giving a wide arc of rotation; 2. Preservation of the superficial peroneal nerve; 3. Primary closure of the donor site.

Adult↗

PubMed1998

The role of CD8+ cells and CD11a in the rejection-reaction of the allogeneic microskin grafting.

By using histological tissue sections and immunohistochemical stains, the rejection-reaction of the allogeneic microskin grafting of rabbit-skin wounds was studied. The results revealed that the rejection started early in the days following transplantation. In the second week following transplantation, severe graft rejection with epithelial destruction was noted. In addition, an increase of CD8+ cells and expression of the adhesion molecule-CD11a-were also noticed and persisted throughout the days following transplantation. These findings suggest that the CD8+ cells and CD11a may play a major role in the rejection of allogeneic skin grafting.

Animals↗

PubMed1997

Effect of growth factors on dermal fibroblast contraction in normal skin and hypertrophic scar.

We have examined the effects of four 'exogenous' growth factors, i.e. PDGF-BB (5 ng/ml), TGF-beta1 (5 ng/ml), bFGF (10 ng/ml) and EGF (10 ng/ml) on the contraction of floating collagen type I lattices populated by human normal skin (NS) and hypertrophic scar (HS) fibroblasts (FPCL). Only TGF-beta1 enhanced the contractility of both NS and HS fibroblasts in the collagen lattice (P < 0.01). Other growth factors (PDGF-BB, bFGF and EGF) did not affect FPCLs contraction at 72 h (P > 0.05). The onset effect of TGF-beta1 on NS-FPCL contraction was relative early at 24 h after FPCL casting as compared to a 72 h delay on HS-FPCL contraction. Besides, PDGF-BB was found to be able to enhance HS-FPCL contraction (P < 0.05) but not on NS-FPCL contraction on day 4. On the other hand, three enzyme-linked immunosorbent assays (ELISA) were performed to demonstrate quantitatively the 'endogenous' growth factors that fibroblasts secreted into the culture medium 48 h after FPCL casting. No appreciable difference was found between 10 NS and 11 HS samples tested for PDGF-AB immunoassay (11.48 +/- 5.5 pg/ml versus 12.20 +/- 5.34 pg/ml). The same result existed in 7 NS and 13 HS samples for TGF-beta2 immunoassay (15.15 +/- 6.2 pg/ml versus 11.84 +/- 7.46 pg/ml). In bFGF immunoassay study, relative variable data was noted in both 7 NS (18.18 +/- 13.18 pg/ml) and 12 HS samples (20.41 +/- 22.36 pg/ml). In conclusion, we suppose that TGF-beta role in wound healing may be due to the secondary exogenous influences. The endogenous ability of TGF-beta2 secretion (quantity) in HS fibroblasts are the same as NS fibroblasts but with delayed timing responses (quality) to exogenous TGF-beta1 effect in the collagen lattice. Further studies with timing-regulated selective specific monoclonal antibodies against the growth factor receptors may provide the therapeutic applications on HS during wound healing.

Becaplermin↗

PubMed1997

The reverse lateral arm adipofascial flap for elbow coverage.

The reverse lateral arm adipofascial flap covered immediately with a skin graft has been used successfully for reconstruction of a cubital fossa defect (caused by avulsion injury) and an exposed olecranon (resulting from recurrent bursitis) in 2 patients. The flap is nourished by the septal perforators of the posterior radial collateral artery, which in turn obtains its blood supply from the interosseous recurrent artery. The distal vascular pedicle should contain a sufficient amount of subcutaneous fat and its underlying fascia to enhance the arterial input and the venous drainage of the flap. The primary benefit of this technique is that the thickness of the flap can be tailored to fit into the defect, and the donor site can be closed primarily without tension. The advantages include satisfactory cosmetic results, a rapid one-stage procedure, no sacrifice of the main artery or local muscle, and avoidance of any long-term immobilization of the involved elbow joint.

Adult↗

PubMed1997

A mixture of allogeneic dermal tissue and autologous microskin grafting of rabbit skin wound.

In a rabbit model, transplantation of largely expanded microskin grafts (expansion ratio 25 X) were studied. In Group I, the autologous microskin grafts were transplanted onto the full-thickness skin defect on the back of a rabbit and were overlaid with Biobrane. In Group II, the autologous microskin grafts were mixed with allogeneic microdermal substance (expansion ratio 25 X) before the transplantation. The percentage of re-epithelialized area to the total grafted wound was analyzed by means of computerized planimetric analyses of photographs of the grafted wounds on days 11 and 13. Biopsies of the grafted wounds were done. On day 11, the mean percentage of Group I was 72.4% and that of Group II was 82.7%. On day 13, they were 82.3% in Group I and 92.3% in Group II. In Group II, the allogeneic dermal tissue did not cause obvious rejection in the neoepithelium. Histological features showed the existence of allogeneic dermal tissue in the grafted wound. The adding of largely expanded allogeneic dermal substance to autologous microskin grafts in Group II provided better circumstances than that in Group I for re-epithelialization of autologous mciroskin grafts.

Animals↗

PubMed1996

Adipofascial flap of the lower leg based on the saphenous artery.

The adipofascial flap of the lower leg based on the saphenous artery is a modification of the saphenous artery flap. It has been used successfully in 5 patients for reconstruction of soft tissue defects around the knee and superior third of the tibia. The size of these flaps ranged from 5 x 12 cm to 5 x 18 cm. All flaps survived completely. These cases had minimal donor site morbidity because their donor sites were closed primarily with the preserved overlying skin.

Adolescent↗

PubMed1996

The lateral calcaneal artery adipofascial flap.

The lateral calcaneal artery adipofascial flap is a modification of the lateral calcaneal artery skin flap. It has been used successfully in five patients. In comparison to the skin flap, it has the advantages of more versatile clinical applications, better aesthetic result of the donor site and sural nerve preservation.

Adipose Tissue↗

PubMed1996

Continuous thoracic epidural anesthesia for breast augmentation.

Thirty consecutive cases were scheduled for submuscular breast augmentation under continuous thoracic epidural anesthesia. The epidural tube was placed into the intervertebral space between the third and fourth thoracic vertebrae. An average of 15 ml of 2% lidocaine with 1:80,000 epinephrine was used as a primary anesthetic agent. There were no significant changes in respiratory function; only a transient elevation of blood pressure and increased heart rate were noted. All cases were successfully anesthetized, except one case (3%) who had a partial analgesic effect and needed to combine general anesthesia. One patient needed a single dose of ephedrine, 20 mg, to treat hypotension. Perioperative complications included transient shivering (33%), stuffy nose (20%), nausea (7%), and shortness of breath (13%). These symptoms were alleviated after reassurance or light sedation and oxygen inhalation. Immediate postoperative pain of the operative site was effectively controlled by injection of local anesthetics through the epidural tube. This study revealed that thoracic epidural anesthesia was feasible, effective, and even better than conventional alternative anesthetic techniques for breast augmentation.

Adult↗

PubMed1996

Early diagnosis of necrotizing fasciitis by utilization of ultrasonography.

Necrotizing fasciitis is a rare and rapid progression soft tissue infection. The only identifiable feature is tissue necrosis along a single fascia plane. Because the skin is initially spared, it is difficult for early recognition prior to extensive tissue destruction. Ultrasonography was used for early diagnosis of this infection in five cases. All 5 patients presented with severe cellulitis. Under the suspicion of necrotizing fasciitis, ultrasonography was performed before surgical debridement. Tissue biopsy was done for histological confirmation of the diagnosis. Three patients were proven to have necrotizing fasciitis and two cellulitis only. The ultrasonographic findings of necrotizing fasciitis included: 1) irregularity of the fascia; 2) abnormal fluid collections along the fascia plane; and 3) diffuse thickening of the fascia when compared with the control site in the normal limb. However, in severe infectious cellulitis, the above mentioned findings were not observed. Our results indicate the usefulness of the ultrasonography for early diagnosis of necrotizing fasciitis.

Adult↗

PubMed1996

Squamous cell carcinoma of the nail bed.

Squamous cell carcinoma of the nail bed is a rare disorder. Metastasis is extremely unusual. A case of primary squamous cell carcinoma of the nail bed with metastasis to the regional lymph nodes is reported. The tumor was successfully treated by amputation of the involved finger, block dissection of the regional lymph nodes, postoperative irradiation of the involved axilla, and systemic chemotherapy. Early diagnosis by biopsy, especially in patients with recurrent and persistent disease of the nail bed, is recommended, so that treatment can be instituted early while the tumor is confined to its primary site.

Adult↗

PubMed1996

Zigzag V-Y advancement flap for medial canthal defect after tumor excision.

A zigzag V-Y advancement flap based on the angular artery is used to repair the medial canthal defect after tumor excision. Only the middle-third subcutaneous attachments to the flap are left intact, which contain the vascular pedicle. The advancing zigzag edges of the flap can be naturally inserted around both limbs of the medial canthus, and this disperses the tendency to linear contracture and "trap-door" scarring. The described technique is an excellent choice for medial canthal defect, providing a well-contoured and aesthetically pleasing reconstruction.

Basal Cell Carcinoma↗

PubMed1995

Running Y-V-plasty for burn scar contracture.

Seventeen patients with 24 regions received running Y-V-plasties to release burn scar contractures over a 3-year period. The scar band can be completely interrupted and lengthened without the need for undermining and transposition of the skin flaps, circulatory embarrassment of the flaps can be avoided. The wound morbidity was extremely low, and no recurrence of the contracture was noted during follow-up periods. The running Y-V-plasty has unique advantages for the treatment of cord-like or linear burn scar contractures. This approach resulted in shorter hospital stay and allows early mobilization of the involved extremities.

Adolescent↗