• Journal of the Korean Society of Food Science and Nutrition
• /
• v.13 no.4
• /
• pp.451-458
• /
• 1984

The effects of branched chain amino acids added to a diet on changes in the body weight with or without liver, moist and dry liver weight, protein, DNA, $^3H-thymidine$ incorporation into DNA, ana mitotic index of regenerating liver were studied in partial hepatectomized rat. Experimental diet was a 14.63% casein diet supplemented with 1.49% L-leucine, 0.90% L-isoleucine and 0.98% L-Valine, and control diet was an 18.0% casein. In both diets, 2.54% nitrogen were included. Rats fed experimental diet were significantly increased body weight with or without liver 7 days, and regenerated weight of dry liver and an index of liver regeneration 5 days after partial hepatectomy. Mitotic index, contents of protein and DNA increased in regenerating liver after partial hepatectomy was higher in experimental diet group. This results suggest that branched chain amino acids have an benefitial effect on whole body as well as liver regeneration after partial hepatectomy in rat.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.1
• /
• pp.14-23
• /
• 2004

Introduction: The hand and wrist are particularly susceptible to electrical burn. Skin defect with damage or exposure of underlying vital structure requires coverage by skin flap especially in case of the need for late reconstruction. We are reporting 4 cases of electrical burned hand treated by posterior tibial arterial free flap. The commonly used skin flaps such as scapular flap or groin flap are too bulky so that they are not satisfactory in function and cosmetic appearance. So we tried to cover them with a more thin skin flap. Materials and Method: From January 2002 to June 2003, four cases of hand and wrist electrical burn were covered using posterior tibial arterial free flap. All the cases were due to high voltage electrical burn. Age ranged from 31 years to 38 years old and all the cases were male patients. Recipient sites were 2 wrist, one thenar area and one knuckle of 2.3rd MP joint. Additional procedures were flexor tenolysis (simultaneous), FPL tenolysis and digital nerve graft (later) and extensor tendon reconstruction (later). Result: All the flap have survived totally without any complication including circulatory concern about the donar foot. Posterior tibail arterial free flap was so thin that debulking procedure was not required. Conclusion: For skin coverage of the hand & wrist region, posterior tibial arterial free flap have many advantages such as reliable anatomy, easy dissection and easy anastmosis with radial or ulnar artery and possibility of sensory flap. The most helpful advantage for hand coverage is its thinness. So we think this flap is one of the very useful armamentarium for reconstructive hand surgery.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.1
• /
• pp.43-50
• /
• 2004

One of the major advantages of microsurgical reconstruction for defects of the hand is that these techniques allow for selection of the most ideal tissue to reconstruct a particular defect, thus optimizing the functional and aesthetic outcome. The dorsalis pedis free flap is an excellent reconstructive tool for various hand reconstructions. It has a reliable vasculature with vessels that are relative large on a long pedicle. It provides thin pliable tissue and be innervated by deep peroneal nerve. Coupled with its thinness and pliability, it is ideal for innervated cover of critically sensitive area, especially such as the hand. Thus it can be used as a cutaneotendinous flap, or an osteocutaneous flap. Otherwise, the major criticism with this flap is related to its uncertain vascularity and the donor defect. It is the purpose of this paper to outline our technique of flap elevation and donor site closure and to indicate our current use of this flap in hand reconstruction. We have treated 10 cases (6 burn scar contracture cases, 4 acute hand trauma cases) of hand reconstruction from Dec. 3, 1997 to Mar. 4, 2004 using dorsalis pedis free flap. The key points for sucess in terms of a viable flap and acceptable donor site are the preservation of the critical dorsalis pedis-first dorsal metatarsal vascular axis and the creation of a viable bed for grafting. In addition, we substituted preserved superficial fat skin graft for split thickness skin graft and wet environment was offered for good graft take. Preserved superficial fat skin is defined as composite graft containing epidermis, dermis and superficial fat layer. With sufficient care in flap elevation and donor site closure, a good graft take of preserved superficial fat skin under wet environment can be achieved with no functional disability and minimal cosmetic deformity in donor site. This flap has proved itself to be a best choice for hand reconstruction.

• Archives of Reconstructive Microsurgery
• /
• v.18 no.2
• /
• pp.62-66
• /
• 2009

Purpose: Despite the free tissue transfer using microsurgical technique being the current trend of soft tissue reconstruction of the hand, the pedicled groin flap has the advantage to provide coverage for the mangled hand without necessitating the use of a damaged arterial system and also providing the benefit of saving the arterial system for later free tissue transfer. This report presents the author's experience using pedicled groin flap in four cases of mangled hands with massive bone and soft tissue defects requiring later thumb reconstruction with the free wrap around flap. Materials and methods: The patients' age ranged from 30 to 51 years; three patients were male and one was female. The causes of mangled hand included two machinery crush injuries, one laboratory explosion and one motor vehicle accident. While evaluating the post-operative results, factors like flap survival, complications, stability in opposition, pinch power and 2 point discrimination were taken into account. Results: All massive soft tissue defects of the hands were completely covered with pedicled groin flap successfully. The reconstructed thumb using free wrap around flap did not have any limitation in opposition. There was no occurrence of post-operative infection and all the flaps survived completely. The average pinch power was 70% of the contralateral intact thumb and average 2 point discrimination was 10 mm. Conclusion: The pedicled groin flap for the reconstruction of the massive soft tissue defects of the hand with subsequent reconstruction of the thumb with a wrap around flap is a very useful procedure. The combined use of pedicled groin flap and wrap around flap allows adequate coverage of sizable soft tissue defects and functional thumb opposition in cases of reconstruction of the mangled hands.

• Journal of Acupuncture Research
• /
• v.22 no.3
• /
• pp.201-213
• /
• 2005

Objective : The aim of this study is to investigate the effectiveness of Bee-venom therapy for Cervical radiculopathy patients. Methods : To evaluate the effectiveness of Bee-venom therapy, 14 patients were treated by Bee-venom therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale (QVAS), JOA score and Odom's degree. Results & Conclusions : 1. As a objectivity treatment record, they test treatment record excellent(7 case) 50%, good(4 case) 28.57%, fair(,3 case) 21.43%. 2. After Bee-venom therapy, pain rate changed from 8.82 to 3.25.(p=0.000) 3. After Bee-venom therapy, JOA score changed from 11.00 to 12.79.(p=0.000) 4. By the results which puts out the statistics in sex, age, existence of finger numbness and disc type, the pain rate is not significantly difference as a therapy. (p<0.05) 5. By the results which puts out the statistics in sex, age and disc type, the JOA score is not significantly difference as a therapy.(p<0.05) But by the results which puts out the statistics in existence of finger numbness the JOA score is significantly difference as a therapy.(p=.025) There was reports about Bee-venom therapy of the Patient with Cervical radiculopathy. It is very effective to reduce the pain and increase the JOA score.

• Journal of Oriental Medical Thermology
• /
• v.5 no.1
• /
• pp.69-77
• /
• 2006

Purpose : There are many patients with cold hypersensitivity who want oriental medicine treatment. But there has been no study of acupucture treatment effect on patients. So we examined effects of acupuncture treatment at different acupuncture points and compared results of 1st cold stress test and 2nd cold stress test. Method : 8 patients with hand cold hypersensitivity applied for this study. To rule out an bias, we excluded the patients with skin diseases, spinal nerve disease of cervial spine, external wounds. We measured body temperature with D.I.T.I. We performed cold stress test(CST) by 6 thermographic observation using D.I.T.I ; the 1st was taken after 15 minutes-resting, the 2nd was immediately taken after 1 minute soak in $20^{\circ}C$ water, the 3rd was taken at 10 minutes after the soak, and after a week, the 4th was taken after 15 minutes resting, the 5th was immediately taken after 1 minute soak in $20^{\circ}C$ water, the 6th was taken after 10 minutes with acupunture treatment. There were two groups of patients. First group was acupuncture that performed acupuncture therapy on distal points. Second group was acupuncture that performed acupuncture therapy on proximal points. We compared first CST and second CST recovery rate result. Results : The recovery rate at distal points acupuncture therapy was higher than before of that. but not significantly different. The recovery rate at proximal points acupuncture therapy was significantly higher than before of that. The recovery rate of both the back, the palms, all fingers of after proximal acupuncture therapy was significantly higher than before of that. Conclusions : Acupuncture could be effective therapy method on cold hypersensitivity, especially using proximal acupuncture points could be good at cold hypersensitivity patients. This was pilot study of very small samples, results had limitations. For further results more examine would be needed.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.396-399
• /
• 2010

Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

• Journal of Chest Surgery
• /
• v.31 no.5
• /
• pp.519-524
• /
• 1998

From January 1996 to December 1996, we performed 137 thoracic sympathetic ganglionectomies with VATs for primary hyperhidrosis in the department of thoracic and cardiovascular surgery at Anam hospital, Korea university medical center. There were 83 men and 54 women whose ages ranged from 13 to 63 years old(mean age: 25years). Of these patients, 128 patients had complained of palmar hyperhidrosis and 26 of facial hyperhidrosis. Thoracoscopic sympathetic ganglionectomies procedures included lower 1/3 Stellate ganglionectomies in 4 patients; lower 1/3 Stellate ganglionectomies and T2-sympathetic ganglionectomies in 18 patients; T2-sympathetic ganglionectomies in 86 patients; T2 and T3 sympathetic ganglionectomies in 10 patients; and T2, T3 and T4 sympathetic ganglionectomies in 19 patients. The mean operating time was 59 minutes(range: 25 to 162 minutes), and the mean hospital stay was 3.8 days(range: 2 to 8 days). Common complications were compensatory hyperhidrosis(109 patients) and causalgia(18 patients). At the end of the follow-up period(mean: 8 months) ninety-seven percent of the patients reported satisfactory results. Thoracic sympathetic ganglionectomy with VATs is an efficient, safe, and minimally invasive surgical procedure for primary hyperhidrosis.

• Archives of Hand and Microsurgery
• /
• v.23 no.4
• /
• pp.254-261
• /
• 2018

Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint. Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically. Results: The average of postoperative ulnar deviation angle was $13.3^{\circ}$ in radial ligament and $2.0^{\circ}$ in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs. Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.

• Archives of Hand and Microsurgery
• /
• v.23 no.4
• /
• pp.223-229
• /
• 2018

Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.