• Archives of Plastic Surgery
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• v.35 no.6
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• pp.755-758
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• 2008

Purpose: In order to determine the amount of wound healing, objective sequential assessments of changes in wound size and depth are essential. Although a variety of measurements for wound healing have been proposed, a gold standard for quantifying day-to-day changes in healing has not been established. We present here a simple and non-invasive wound measurement method that quantitatively and accurately documents changes of the size of a raw surface and the volume of a soft tissue defect using a stereoimage optical topometer(SOT) system. Methods: Using a 5mm diameter biopsy punch, four circular wounds were created on abdominal area of a diabetic mouse. Photographs were taken using SOT system at baseline, 5th day and 10th postoperative day. The wound margin was traced on a digitalized photo and evaluated the area and the volume of the wound by SOT system. Results: The SOT system calculated a mean wound surface of $15.93{\pm}0.29mm^2$ and volume of $827.50{\pm}88.86$ intensity/pixel${\times}$area(I/PA) immediately after wounding. On the 5th day after the operation wound surface declined by $10.73mm^2$ and on the 10th day declined by $5.95mm^2$. The wound volume also declined from 827.50 I/PA to 161.75 I/PA and 30.50 I/PA on 0, 5th and 10th day, respectively. Conclusion: The SOT system described in this study represents a reliable, simple, practical, and non-invasive technique to accurately monitor and evaluate wound healing.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.213-217
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• 2014

The widespread use of microsurgery in numerous surgical fields has increased the need for basic microsurgical training outside of the operating room. The traditional start of microsurgical training has been in undertaking a 5-day basic microsurgery course. In an era characterised by financial constraints in academic and healthcare institutions as well as increasing emphasis on patient safety, there has been a shift in microsurgery training to simulation environments. This paper reviews the stepwise framework of microsurgical skill acquisition providing a cost analysis of basic microsurgery courses in order to aid planning and dissemination of microsurgical training worldwide.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.44-46
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• 2019

Gorham-Stout disease (GSD) was first described by Gorham and colleagues in 1954, but its precise mechanism and cause remain to be elucidated. In this condition, voluminous and potentially fatal chylous effusions into the thorax can occur. Herein, we describe a case of GSD in which the patient presented with massive pleural effusions and mottled osteolytic bone lesions. We performed multiple operations, including thoracic duct ligation using video-assisted thoracoscopic surgery and thoracotomic decortication, but these procedures did not succeed in preventing recurrent pleural effusion and chest wall lymphedema. After administering sirolimus ($0.8mg/m^2$, twice a day) and propranolol (40 mg, twice a day), the process of GSD in this patient has been controlled for more than 2 years.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.181-186
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• 2013

Background Partial or complete necrosis of a skin flap is a common problem. Polydeoxyribonucleotide (PDRN) can be extracted from trout sperm and used as a tissue repair agent. The aim of this study was to investigate whether PDRN could improve the survival of random pattern skin flaps in rats. Methods Twenty-two male Sprague-Dawley rats were randomly divided into two groups: the PDRN treatment group (n=11) and the control group (n=11). Caudally pedicled random pattern skin flaps were elevated on their dorsal skin and resutured. The treatment group received daily intraperitoneal administration of PDRN (8 mg/kg/day), and the control group received fluid vehicle (NaCl 0.9%, 8 mg/kg/day) from day 0 to day 6. On day 7, the flap survival was evaluated and the harvested tissue surrounding the demarcation line of the necrotic area was stained with H&E, anti-rat vascular endothelial cell growth factor (VEGF) antibody, and PECAM-1/CD31 antibody. Results The average necrotic area of the flap in the PDRN group was significantly smaller when compared with that of the control group. Histologic and immunohistochemical evaluation showed that granulation thickness score and VEGF-positive staining cells were marked higher in the PDRN group than in the control group. PECAM-1/CD31-positive microvascular densities were significantly higher in the PDRN group when compared with the control group. Conclusions This study confirms that PDRN improves the survival of random pattern skin flaps in rats. These results may represent a new therapeutic approach to enhancing flap viability and achieving faster wound repair.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1136-1138
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• 1997

A 45-year-old man underwent heart transplantation due to dilated cardiomyopathy. Cyclosporine, 2 mg/kg per day, was intravenously givell postoperatively. As central neurotoxicity signs that were included pin-point pupil, no light reflex, coma, were presented at 8 postoperative hours, cyclosporine was decreased to 1 mg/kg er day. At that time the cyclosporine level was 345 $\mu\textrm{g}$/L, the serum creatinine level was 1.8mg/dl and the serum magnesium level was within normal limit. He awaked at 31 postoperative hours and all sign of cyclosporine-induced central neurotoxicity was resolved after postoperative days. He was discharged without sequale at postoperative day 28.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.172-179
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• 2018

Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

• Journal of Acupuncture Research
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• v.28 no.5
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• pp.77-86
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• 2011

Objective : This study was designed to evaluate the effect of bee venom pharmacopuncture therapy in patients with FBSS(failed back surgery syndrome). Methods : We investigated 30 cases of patients with FBSS, who had been treated from October 2010 to July 2011. We divided patients into two groups : group I was treated by acupuncture therapy only, and group II was treated by bee venom pharmacopuncture therapy and general acupuncture. We measured the efficacy of treatments using the numerical rating scale(NRS) and grade and straight leg raising(SLR) test. Results : 1. The treatment method for group II was more effective than that of group I in reducing the NRS score on the fifteenth day after admission but there was no statistically significant difference between the results of two groups on the fifth day after admission and the tenth day after admission. 2. The treatment method for group II was more effective than that of group I in NRS improvement rate from its admission day to the fifth day after admission and from the tenth day after admission to the fifteenth day after admission but there was no statistically significant difference between the performance of two groups from the fifth day after admission to the tenth day after admission. 3. Group II had a higher grade improvement rate from the seventh day after admission to the fifteenth day after admission than group I but no statistically significant difference was observed between the results of two groups from its admission day to the seventh day after admission. 4. In SLR test improvement rate the treatments applied to group II was more effective than those applied to group I. Conclusion : The results of this study suggest that bee venom pharmacopuncture therapy is effective in reducing pain for patients with FBSS. Further clinical research is needed to verify these results and findings.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.732-736
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• 2006

Purpose: The purpose of this pilot study was to investigate a potential of platelet concentrate obtained from blood bank(PCBB) in accelerating wound healing and to determine an effective treatment protocol by quantifying levels of platelet derived growth factor (PDGF)-BB in PCBB in vitro. Methods: The first study was designed to investigate quantity of PDGF-BB over stored time of the PCBB. The stored times for each PCBB were 1, 3, 5, 7, 9, 11 and 13 days. The second study was designed to determine efficacy of adding thrombin to stimulate release of PDGF-BB from the platelets of PCBB. The platelets were suspended and incubated in either with or without thrombin. On 30 minutes and days 1, 3, 5, 7 after incubation, the levels of PDGF-BB were measured. Results: PDGF-BB level showed a linear decrease over stored time of PCBB from the first day to the 13th day. Addition of thrombin increased PDGF-BB release from 30 minute through the 5th day. Conclusion: The results indicate that PCBB can provide sufficient amount of growth factors to stimulate wound healing and adding thrombin accelerate it.

• Journal of Embryo Transfer
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• v.17 no.2
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• pp.123-128
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• 2002

The present study aimed at determining the effective dose of Folltropin, a follicle timulating hormone (FSH), on superovulation in indigenous cows of Bangladesh. Fifteen regularly cycling 5～7 years old dry cows, weighing 200～250 kg with 2.5～3.0 body condition scores (BCS) were divided into three groups (n＝5). Individual groups were superovulated with 100, 200 or 300 mg of Folltropin per animal. The superovulation treatment was initiated at Day 10 or Day 11 of the estrous cycle (Day 0＝day of estrus). Alfaprostol (6 mg) was injected to each cow 72 h after the initiation of superovulation treatment to induce eestrus. After confirming standing estrus, the cows were inseminated 2～3 times, 12 h apart, depending on the duration of estrus. At Day 6 or Day 7, individual horns of the uterus were flushed with 150～200 $m\ell$ of phosphate buffered saline supplemented with BSA (0.2％), penicillin (100 IU／$m\ell$) and streptomycin (100 $\mu\textrm{g}$／$m\ell$) using a two-way foley catheter. The embryos were concentrated, removing the excess medium through an embryo filter, and identified under a stereomicroscope. The identified embryos were collected, washed four times, evaluated and graded as excellent, good, fair or poor. The excellent, good and fair embryos were considered as transferable quality embryos. The mean (range). numbers of embryos collected vs. transferable quality embryos far 100, 200 and 300 mg of Folltropin were 4.5 (1～10) vs. 3.5 (1～8); 2.5 (1～4) vs. 1 (0～2) and 0.0 (0～0) vs. 0.0 (0～0), respectively, Folltropin at a dose of 100 or 200 mg produced suitable ovarian stimulation for superovulation in indigenous zebu cows of Bangladesh. A dose of 300 mg or more Folltropin consistently caused preovulatory corpora lutea formation in the ovaries and resulted in zero embryo recovery.

• Archives of Plastic Surgery
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• v.43 no.6
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• pp.491-497
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• 2016

Background Hypertrophic scarring is a pathological condition that occurs after trauma or surgery. Angiogenesis occurs more often with hypertrophic scarring than with normotrophic scarring. The regulation of angiogenesis is one of the key factors in hypertrophic scar management. Vascular endothelial growth factor (VEGF) is an essential factor in the angiogenetic response. This study investigated whether decreasing the level of VEGF is effective for treating hypertrophic scarring. Methods Ten 8-week-old female New Zealand white rabbits were included. Four defects were created on each ear by using a 6-mm punch. Bevacizumab (Avastin, Roche Pharma, Basel, Switzerland) was administered in one ear and normal saline was administered in the other ear. Treatment was administered starting on day 2, every 2 days, until day 14. The levels of VEGF were measured using enzyme-linked immunosorbent assay on day 10 and histologic results were analyzed on day 40. Results Bevacizumab induced-defects showed less hypertrophic scarring when compared with the control group as measured by the scar elevation index (SEI) and loose collagen arrangement. The SEI in the experimental group was $1.89{\pm}0.13$, compared to $1.99{\pm}0.13$ in the control group (n=30, P=0.005). Additionally, the VEGF level was lower ($38.72{\pm}11.03pg$ vs. $82.50{\pm}21.64pg$, n=10, P=0.001) and fewer vessels existed ($8.58{\pm}0.76$ vs. $7.2{\pm}1.20$, n=10, P=0.007). Conclusions Preventing excessive angiogenesis is effective for preventing scar formation, especially with hypertrophic scarring. Although it is not an approach that is sufficient alone for the management of scarring, it may be one of several important strategies for scar treatment.