• Archives of Plastic Surgery
• /
• v.36 no.2
• /
• pp.205-210
• /
• 2009

Purpose: Corrugator supercilii muscle pulls eyebrow to inferomedial direction and produces the vertical component of the glabellar line formation. Current techniques for eliminating of glabellar frown include direct resection of corrugators and botulinum toxin injection. Muscle resection in endoscopic face lift procedure is relatively complex and has many disadvantages ranging from possible nerve injury, postoperative edema, pain and a long recovery period. The Botox treatment on the other hand is much more simple in technique but has a short duration of action. The authors have attempted new ways of finding improved treatment of the glabellar frown by selectively blocking of motor nerves innervating the corrugator supercili muscle by using radiofrequency ablation technique. Methods: A total of 80 patients were recruited in our study during the period between Feb. 2007 to June 2008. A probe was introduced from the supraorbital ridge and advanced to the corrugator supercilii muscle. Nerve stimulator was then used to locate the nerve innervating the corrugator and radiofrequency ablation of the nerve was done. Results: In all patients, there were marked improvement in glabellar frown after treatment. There were no reported cases of any relapses during the follow up period. No complication was noted such as facial nerve injury. No patient complained of any adverse symptoms other than slight discomfort due to swelling of the operation site. Conclusion: The treatment of glabellar frown lines using selective nerve block with radiofrequency ablation was not only less invasive but also excellent in surgical outcomes.

• The Korean Journal of Physiology and Pharmacology
• /
• v.27 no.3
• /
• pp.257-265
• /
• 2023

Kidney ischemia/reperfusion (I/R) injury, a common cause of acute kidney injury (AKI), is associated with the migration of inflammatory cells into the kidney. Ras-related C3 botulinum toxin substrate 1 (Rac1), a member of the Rho family of small GTPase, plays an important role in inflammatory cell migration by cytoskeleton rearrangement. Here, we investigated the role of Rac1 on kidney I/R injury and macrophage migration. Male mice were subjected to either 25 min of bilateral ischemia followed by reperfusion (I/R) or a sham operation. Some mice were administrated with either NSC23766, an inhibitor of Rac1, or 0.9% NaCl (vehicle). Kidney damage and Rac1 activity and expression were measured. The migration and lamellipodia formation of RAW264.7 cells, mouse monocyte/macrophage, induced by monocyte chemoattractant protein-1 (MCP-1, a chemokine) were determined using transwell migration assay and phalloidin staining, respectively. In sham-operated kidneys, Rac1 was expressed in tubular cells and interstitial cells. In I/R-injured kidneys, Rac1 expression was decreased in tubule cells in correlation with the damage of tubular cells, whereas Rac1 expression increased in the interstitium in correlation with an increased population of F4/80 cells, monocytes/macrophages. I/R increased Rac1 activity without changing total Rac1 expression in the whole kidney lysates. NSC23766 administration blocked Rac1 activation and protected the kidney against I/R-induced kidney damage and interstitial F4/80 cell increase. NSC23766 suppressed monocyte MCP-1-induced lamellipodia and filopodia formation and migration of RAW 264.7 cells. These results indicate Rac1 inhibition protects the kidney against I/R via inhibition of monocytes/macrophages migration into the kidney.

• Clinical Pain
• /
• v.18 no.2
• /
• pp.92-96
• /
• 2019

Torticollis is an abnormal, asymmetric head or neck position which usually caused by imbalance of paracervical muscles. The traumatic torticollis can be caused by following events; atlantoaxial rotatory subluxation, atlantoaxial dislocation, cervical vertebral fractures, and injury to the cervical musculature. Especially, acute traumatic atlantoaxial rotatory subluxation usually presents limitation of cervical range of motion without pain or neurologic deficit. We report a case of a 58 year-old man who developed the acute atlantoaxial rotatory subluxation right after the chiropractic therapy, which induced the limitation of cervical range of motion to 52.5% of normal range. The magnetic resonance image revealed the facture of the odontoid process and the partial injury in transverse ligaments of the atlas. He underwent intramuscular botulinum toxin injection and 10 days of continuous cervical traction 15 hours a day using a 5 kg weight. The range of the cervical motion restored up to 90.2% of normal range.

• Experimental and Molecular Medicine
• /
• v.51 no.2
• /
• pp.9.1-9.10
• /
• 2019

Mesangial cell proliferation has been identified as a major factor contributing to glomerulosclerosis, which is a typical symptom of diabetic nephropathy (DN). Lysophosphatidic acid (LPA) levels are increased in the glomerulus of the kidney in diabetic mice. LPA is a critical regulator that induces mesangial cell proliferation; however, its effect and molecular mechanisms remain unknown. The proportion of ${\alpha}-SMA^+/PCNA^+$ cells was increased in the kidney cortex of db/db mice compared with control mice. Treatment with LPA concomitantly increased the proliferation of mouse mesangial cells (SV40 MES13) and the expression of cyclin D1 and CDK4. On the other hand, the expression of $p27^{Kip1}$ was decreased. The expression of $Kr{\ddot{u}}ppel$-like factor 5 (KLF5) was upregulated in the kidney cortex of db/db mice and LPA-treated SV40 MES13 cells. RNAi-mediated silencing of KLF5 reversed these effects and inhibited the proliferation of LPA-treated cells. Mitogen-activated protein kinases (MAPKs) were activated, and the expression of early growth response 1 (Egr1) was subsequently increased in LPA-treated SV40 MES13 cells and the kidney cortex of db/db mice. Moreover, LPA significantly increased the activity of the Ras-related C3 botulinum toxin substrate (Rac1) GTPase in SV40 MES13 cells, and the dominant-negative form of Rac1 partially inhibited the phosphorylation of p38 and upregulation of Egr1 and KLF5 induced by LPA. LPA-induced hyperproliferation was attenuated by the inhibition of Rac1 activity. Based on these results, the Rac1/MAPK/KLF5 signaling pathway was one of the mechanisms by which LPA induced mesangial cell proliferation in DN models.

• The Korean Journal of Pain
• /
• v.31 no.3
• /
• pp.155-173
• /
• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.2
• /
• pp.142-146
• /
• 2007

Objectives and Backgrounds : After parotidectomy, some of patients complain gustatory sweating, facial flushing and discomfort in the same area. A series of these symptoms are supposed to be caused by the aberrant regeneration of the secretory parasympathetic fibers to sweat glands and blood vessels of the skin following parotidectomy. In this study, we want to compare the efficacy of thermography to the Minor's starch-iodine test for determining the presence of Frey's syndrome. Materials and Methods : 48 patients who underwent total or superficial parotidectomy from March 2002 to December 2004 were selected for this study. A subjective clinical questionnaire and the objective Minor's starchiodine test were performed to evaluate the incidence of this syndrome. Total 21 patients were confirmed as positive Frey's syndrome and infrared thermography was performed for them. Result : Frey's syndrome occurred in 21 patients(43.8%). The average temperature of parotidectomy site and normal opposite area were $27.65^{\circ}C\;and\;26.41^{\circ}C$ respectively. Thermography showed temperature difference in 20 patient(95.2%) and the difference of temperature was statistically significant above $1.0^{\circ}C$(p<0.001). The severity of symptoms were related with the difference of temperature(p<0.05). Conclusion : Thermography is useful, non-invasive, simple and quantifying method to diagnose Frey's syndrome. Additionally, this geographic diagnosis is available to show the accurate area for botulinum toxin injection.

• The Journal of Korean Medicine
• /
• v.40 no.3
• /
• pp.35-58
• /
• 2019

Objectives: The aim of this study was to investigate the anti-inflammatory effects of Curcuma longa rhizoma extract in an experimental rat model of osteoarthritis. Methods: Osteoarthritis was induced in rats by injecting monosodium iodoacetate (MIA) into the knee joint cavity of rats. The rats were divided into 5 groups (Normal, Control, positive comparison, low (CL) and high (CH) concentration groups). Rats in the low concentration (CL) group had MIA-induced osteoarthritis; they were treated with Curcuma longa rhizoma extract at a dose of 50mg/kg body weight. Rats in the high concentration (CH) group had MIA-induced osteoarthritis; they were treated with Curcuma longa rhizoma extract at a dose of 100mg/kg body weight. Hind paw weight distribution and ROS levels were measured. At the end of all treatments, changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine levels were analyzed. In addition, inflammatory protein levels were evaluated by western blot analysis. Results: In this study, hind paw weight distribution significantly improved in the CL and CH groups, while. Reactive oxygen species (ROS) production significantly decreased in both. The levels of ALT, AST, BUN, and creatinine did not significantly change in either group. The production of nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4), $p47^{phox}$, and Ras-related C3 botulinum toxin substrate 1 (RAC1) decreased in both. Catalase, heme oxygenase-1 (HO-1) and superoxide dismutase (SOD) significantly increased in the CL and CH groups, respectively. Nuclear factor erythroid 2 (Nrf2) increased, but there were no significant differences between the experimental and control groups. Inflammatory cytokines, including nuclear factor-kappa Bp65 (NF-${\kappa}Bp65$), interleukin-1beta (IL-$1{\beta}$), and tumor necrosis factor-alpha (TNF-${\alpha}$), decreased significantly in both the CL and CH groups. Conclusions: Our results showed that Curcuma longa rhizoma extract has anti-inflammatory effects. Anti-inflammatory activity is regulated by the inhibition of inflammatory cytokines and mediators, such as NF-${\kappa}B$, therefore, it suppresses cartilage damage as well.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.24 no.4
• /
• pp.533-542
• /
• 2010

Skin aging is a natural phenomenon. There are internal and external factors of skin aging. The internal factor of skin aging is from the wearing down of the body over time. The external factors are more noticeable from habits such as smoking, excessive alcohol, malnutrition, and extended exposure to UV rays. Completely stopping skin from aging is impossible but one can slow down and treat external signs of skin aging. In western medicine, the following methods are used to reduce the appearance of skin aging: applying lotions and creams containing ingredients such as fruit acid, antioxidants, plant exracts, depigmentation, moisturizer, retinoids, and sun block; botulinum toxin injections; chemical peels, laser and other painful methods remove the top layer of skin to promote new skin growth; fillers are injected to increase soft tissue growth; surgery. In oriental medicine, the following methods are used: acupuncture into facial muscles which stimulates acupuncture point; applying topical treatments and cosmetics containing herbs are effective of preventing skin aging and wrinkles. Above all thing, medicine that helps maintain essence and blood in the skin can be fundamental.

• Journal of the Korean Society of Physical Medicine
• /
• v.7 no.3
• /
• pp.339-348
• /
• 2012

Purpose : The purpose of this study is to compare muscle activations of neck, trunk and leg in cerebral palsy of spastic diplegia with genu recurvatum and knee flexion contracture, when using anterior and posterior walkers. Methods : We selected 21 cerebral palsy and received the written consent to participate in this study. The inclusion criteria for participation required patients to have spastic diplegic CP; to be between 3~6 years of age, to have a GMFCS III grade, to have no botulinum toxin injection and orthopedics surgery within before six months starting the study. Measurements of muscle activities (sternocleidomastoid, splenius capitis, rectus abdominis, erector spinea, gluteus maximus, rectus femoris, medial hamstring and calf muscles) were evaluated anterior and posterior walker ambulations. Statistical evaluation of these data were accomplished by utilizing the paired t-test and independent t-test by SPSS 20.0 program. Significance level was set at p<.05. Results : The following results were obtained. There was significant difference on muscle activation of neck, trunk and legs(soleus except) in anterior and posterior walkers. There was no significant difference in muscle activation of neck but significant difference in muscle activation of trunk, legs between genu recurvatum and knee flexion contracture(rectus abdominis, medial hamstring when using anterior walker, rectus abdominis, erector spinea, gluteus maximus, medial hamstring when using posterior walker). Conclusion : The conclusion of this study is the different knee joint forms would have different effect on muscle activation of trunk and legs while cerebral palsy of spastic diplegic ambulated with anterior walker and posterior walker.

• Journal of the Society of Cosmetic Scientists of Korea
• /
• v.44 no.4
• /
• pp.447-453
• /
• 2018

Acetyl hexapeptide 8 (AH8) is a synthetic peptide for anti-wrinkle cosmetics ingredient. It was developed as a mimetic of botox, patternd after N -terminal end of the protein synatosomal-associated protein 25 (SNAP25), a substrate of botulinum toxin. While AH8 has good efficacy and safety profiles, the permeation through the skin is poor. Therefore, we tried to enhance the transdermal delivery of AH8 by using of hyaluonic acid (HA), a linear polysaccharide of N-acetyl glucosamine and glucuronic acid. To investigate the effect of HA on AH8 penetration, we analyzed paraffin sections of $Micropig^{(R)}$ skin. Fluorescence labeled AH8 was applied to micropig skin with or without HA. The absorption of AH8 was limited to the stratum corneum (SC) without HA. On the other hand, AH8 penetrated to the dermis with HA. Especially, low molecular weight HA (5 kDa) was most efficient compared to 500 kDa HA and 2000 kDa HA. Experiments using fourier-transform infrared (FTIR) spectroscopy revealed that lower molecular weight HA had a tendency to increase the fluidity of the SC lipids more, which means enhancing the skin penetration. Therefore, HA could be expected to enhance the anti-wrinkle effect of AH8.