• Title/Summary/Keyword: Deep tissue

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A Multicenter Noncomparative Clinical Study on Midface Rejuvenation Using a Nonabsorbable Polypropylene Mesh: Evaluation of Efficacy and Safety

  • Pak, Chang Sik;Chang, Lan Sook;Lee, Hobin;Jeong, Jae Hoon;Jeong, Jinwook;Yoon, Eul-Sik;Heo, Chan Yeong
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.572-579
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    • 2015
  • Background Facial rejuvenation can be achieved using a variety of techniques. Since minimally invasive procedures for face lifting have become popular because of their convenience and short operating time, numerous minimally invasive surgical procedures have been developed. In this study, a nonabsorbable polypropylene mesh is introduced as a new face lifting instrument, with the nasolabial fold as the main target area. In this paper, we report the efficacy and safety of a polypropylene mesh in midface rejuvenation. Methods Thirty-three subjects with moderate-to-severe nasolabial folds were enrolled from two medical institutions for a noncomparative single-sample study. A mesh was inserted above the superficial muscular aponeurotic system layer, reaching the nasolabial folds through a temporal scalp incision. After 3 weeks, the temporal end of the mesh was pulled to provide a lifting effect. Then, the mesh was fixed to the deep temporal fascia using nonabsorbable sutures. To evaluate efficacy, we compared the scores on the Wrinkle Severity Rating Scale and a visual analog scale for patient satisfaction between the baseline and 7 weeks postoperatively. In addition, we evaluated safety based on the incidence of adverse events. Results The treatment was deemed effective at improving wrinkles in 23 of 28 cases, and patient satisfaction improved significantly during the study period. There were seven cases of skin or subcutaneous tissue complications, including edema and erythema, but there were no suspected serious adverse events. Conclusions Face lifting using a nonabsorbable mesh can improve nasolabial folds without serious adverse effects. Thus, this technique is safe and effective for midface rejuvenation.

Minimal Invasive Plate Osteosynthesis in Proximal Humerus Fractures (상완골 근위부 골절에서의 최소 침습적 금속판 술식)

  • Shin, Sang-Jin;Do, Nam-Hun;Song, Mi-Hyun;Sohn, Hoon-Sang
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.202-208
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    • 2010
  • Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.

Cryoanalgesia for the Post-thoracotomy Pain (늑간 신경 냉동요법에 의한 개흉술후 흉부 동통 관리)

  • Kim, Uk-Jin;Choe, Yeong-Ho;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.54-63
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    • 1991
  • Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

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Myxofibrosarcoma Originating from Chest Wall (흉벽에서 발생한 점액성섬유육종)

  • Cha, Byung-Ki;Lee, Mi-Kyung;Lee, Sam-Youn;Choi, Chong-Bum;Choi, Soon-Ho
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.166-170
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    • 2006
  • Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8 ${\times}$ 6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindleshaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.

The Heel Reconstruction by Microsurgery (미세수술을 이용한 발뒤꿈치 재건)

  • Lee, Kwang-Suk;Huh, Chang-Young;Kim, Hak-Yoon;Suh, Jeong-Dae
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.24-31
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    • 1994
  • The heel, with its specialized fat for shock absorption at heel strike and large surface area for balance and weight bearing, is a important component of normal ambulation. Despite of distinguished improvement in the field of microsurgical free flaps, the choice of reconstruction of the heel has been remained controversial. We reviewed 22 cases of the heel reconstruction using vascularized free flaps from January, 1980 through May, 1993 at the Department of Orthopedic Surgery of Korea University Hospital. The results were as follows: 1. The etiology was traumatic in 21 cases, and chronic ulceration due to burn in 1. 2. The arteries used in free flaps were 11 dorsalis pedis arteries, 2 deep circumflex iliac arteries, 2 supeficial iliac arteries, 2 branches of lateral femoral circumflex iliac arteries, 2 radial arteries, and 3 thorcodorsal arteries. 3. The mean size of the vascularized bone was $4.5cm{\times}3.5cm$, and that of skin flap was $12.1cm{\times}9.2cm$. 4. Of the 22 cases, 19 had a successful outcome and 3 in failure, the causes of failure were thrombosis and infection.

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The Evaluation of Non-Ionizing Radiation (Near-Infrared Radiation) based Medical Imaging Application : Diabetes Foot (비전리 방사선 (근적외선) 기반 의료영상 활용 가능성 평가: 당뇨발)

  • Jung, Young-Jin;Shin, Cheol-Won;Ahn, Sung-Min;Hong, Jun-Yong;Ahn, Yun-Jin;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.399-406
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    • 2016
  • Near-infrared radiation (NIR) is non-ionizing, non-invasive, and deep tissue penetration in biological material, thereby increasing research interests as a medical imaging technique in the world. However, the use of current near-infrared medical image is extremely limited in Korea (ROK) since it is not well known among radiologic technologists and radiological researchers. Therefore to strengthen the knowledge for NIR medical imaging is necessary so as to prepare a qualified radiological professionals to serve medical images in high-quality on the clinical sites. In this study, an overview of the features and principles of NIR imaging was demonstrated. The latest research topics and worldwide research trends were introduced for radiologic technologist to reinforce their technical skills. In particular, wound care and diabetic foot which have high feasibility for clinical translation were introduced in order to contribute to accelerating NIR research for developing the field of radiological science.

PRE-ORTHODONTIC TREATMENT WITH MYOFUNCTIONAL APPLIANCE (근기능장치를 이용한 교정 전 치료)

  • Kim, Min-Soo;Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.620-627
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    • 2005
  • The purposes of early orthodontic intervention are to correct obvious problems, to intercept developing problems and prevent them from becoming worse. Myofunctional influence on facial growth and the dentition change in muscle function and initiate morphologic variation in the normal configuration of the teeth and enhance an already existing malocclusion. Myofunctional therapy has been advocated since 1960's as the treatment for tongue thrust and other oral habits. Pre-orthodontic $TRAINER^{(R)}$ is introduced as functional device usable in children of mixed dentition to correct functional problems concerning soft tissue, tooth and skeleton. The most common cases to treat with Pre-orthodontic $TRAINER^{(R)}$ are lower anterior crowding, anterior open bite, Class II malocclusion and deep bite. Also, it can be used as correction of oral habits. Patients in this cases visited Department of Pediatric Dentistry, School of dentistry, Dankook University for orthodontic treatment. Pre-orthodontic treatment with Pre-orthodontic $TRAINER^{(R)}$ was carried out for correction of the oral habits.

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LOCALIZED SCLERODERMA IN A CHILD : CASE REPORT (소아 피부 경화증 환자의 치험례)

  • Kim, Eun-Young;You, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.256-261
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    • 2005
  • Scleroderma is a connective tissue disease of unknown etiology, but known as a kind of auto-immune disease. It is most common in women especially in $30{\sim}50$ years, and very rare in childhood. It can be classified into two main classes : localized scleroderma & systemic sclerosis. Localized type has better prognosis, and usually involves skin only, or in some cases, the muscle below, except inner organs. Systemic type involves skin, oral mucosa and major internal organs. Involving facial skin, we can see small and sharp nose, expressionless stare and narrow oral aperture. Usually they have Raynaud's phenomenon, and in progress, show mouth opening limitation and sclerosis of tongue and gingiva. It is called CREST syndrome showing calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangioectasia. Treatment of scleroderma is systemic and localized steroid therapy, use of collagen-link inhibitor (D-penicillamine), immune depressor and etc. Mouth opening limitation can be improved by mouth stretching exercise. We report a 6 years old boy, diagnosed with localized scleroderma who had mouth opening limitation. We could get additional mouth opening, and have done successful restorative treatment of mandibular and maxillary 1st and 2nd deciduous molar under deep sedation with nitrous oxide and enflurane.

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The Effects of Gamchomahwang-tang extract According to the ratio of 2 compounds on the Ovalbumin-Induced Allergic Asthma in Mice (甘草麻黃湯 추출물의 배합 비율에 따른 투여가 Ovalbumin으로 유발된 천식 생쥐에 미치는 영향)

  • Jo, So-Hyun;Jo, Eun-Hee;Park, Min-Cheol
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.4
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    • pp.74-91
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    • 2015
  • Background and Objective : Asthma is a chronic inflammatory disease at the mucosa and is associated with excess production of Th2 cytokine and eosinophil accumulation in lung.Gamchomahwang-tangextract(GME) is one of the well known prescription used in oriental medicine for treating asthma. This study was designed to compare the anti-asthmatic effect of GME according to the ratio of 2 compounds.Methods : To examine the effects of GME on asthma, mice were sensitized with 100 ㎍ of OVA and 1 ㎎ of aluminum potassium sulfate(Alum; Sigma) intraperitoneally on day 1 and 15. From day 22, mice were challenged on 3 consecutive days with 5% OVA. The anti-asthmatic effects of GME were evaluated by enhanced pause(Penh), bronchoalveolar lavage fluids (BALF), inflammatory cytokine production and genes expression, serum IgE production. and histological change in lung tissue. GMEⅠ consists of ES and GU in the proportion 2:1(300 ㎎/㎏ group), GMEⅡ consist of ES and GU in the proprtion 4:1(300 ㎎/㎏ group).Results : GMEⅠ,Ⅱ generally inhibited lung inflammation, inflammatory cells infiltration and cytokine production and gene expression such as IL-4, IL-5 and IL-13 in BALF and serum IgE level. GMEⅡ significantly reduced the cytokine production and gene expression such as IL-4, IL-5 and IL-13 in BALF and GMEⅠ decreased cytokine production of IL-4, IL-13 in BALF and gene expression of IL-4, IL-5 in Lung. GMEⅡ potently inhibited the development of Penh and also reduced the number of eosinophil during OVA-induced AHR(airway hyper-reactivity). Overall the results show that GMEⅡ has more effect on inhibiting production, gene expression of cytokine, serum IgE level and development of Penh than GMEⅠ. Consequently, GMEⅡ might be more effective than GMEⅠ at inhibiting allergic asthma on the OVA-induced mice model.Conclusion : These results indicate that GME has a deep inhibitory effects on airway inflammation and hyperresponsiveness in mice model of asthma and that suppression of IL-4, IL-5, IL-13 expression and decrease of IL-4, IL-5, IL-13 production in BALF might contribute this effect. Hence, the results indicate that GME might be useful herbal medicine of allergic asthma. As a result, GMEⅡ mght be superior to GMEⅠ in the aspect of anti-asthmatic effect on the OVA-induced mice model.

THE ROLE OF REACTIVE OXYGEN SPECIES ON UVA-INDUCED AGING OF DERMAL COLLAGEN (진피 콜라겐의 노화에 대한 활성산소와 자외선의 영향)

  • Kang, S.J.;Hong, S.D.;Cho, W.G.;Chae, Q.
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.18 no.1
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    • pp.64-80
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    • 1992
  • Considerable interest has been generated in age-related non-enzymatic glycosylation and crosslinking of collagen in view of its extracellular nature, and its long biological half-life. The effects of UVA, which penetrates deep in dermis, and reactive oxygen species (ROS) on age- related changes of dermal collagen were studied. The amount of nonenzymatic glycosylation, fragmentation, and crosslinking of collagen were monitored from the mixtures of Type I collagen from calf skin and glucose, irradiated by UVA, with or without scavengers of ROS. At both high and low glucose dosages, non-enzymatic glycosylation was not affected by UVA irradiation. At high glucose dosage, however, glycosylation was reduced by the scavengers of superoxide radical and singlet oxygen, bolt not by hydroxyl radical scavengers. Fragmentation was increased by UVA and decreased by all ROS scavengers. Crosslinking was also enhanced by UVA, and effectively blocked crosslinking. Superoxide radical and singlet oxygen, which were produced by autoxidation of glucose independently to UVA, may encounter the initial phase of glycation. ROS generated from Amadory compounds by UVA enhanced fragmentation and crosslinking Hydroxyl radical was thought to be a major ROS affecting crosslinking. These results suggest that UVA and ROS are able to enhance age-related structural changes of collagen, as affecting many other tissue and cellular components.

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