• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.46-52
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• 2008

Purpose: This study examined the outcomes of reconstruction of the coracoclavicular ligaments with using two suture anchors and performing coracoacromial ligament transfer in patients with acromioclavicular dislocation. Material and methods: Forty patients with complete acromioclavicular dislocation were included in this study. According to the preoperative radiographs, 5 patients with AC dislocations were diagnosed as type III, 4 patients as type IV and 31 patients as type V. Two 3.5mm suture anchors with four strands of nonabsorbable sutures were separately placed on the anterolateral and posteromedial portion of the base of the coracoid process to stabilize the distal clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle for augmentation. Results: At a mean follow-up of 28 months, the average Constant score improved to 97 points. All the patients returned to normal life at an average of 3.2 months postoperatively. At the last follow-up, 37 patients achieved anatomical reduction and three patients showed complete redislocation. However, the clinical results of the patients with redislocation were satisfactory. Conclusion: Anatomical coracoclavicular reconstruction using two suture anchors and coracoacromial ligament transfer for treating complete acromioclavicular dislocation is a safe, effective procedure for restoring a physiologically stable acromioclavicular joint.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.645-652
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• 2008

Purpose: In skin flap surgery, surgeons often encounter distal ischemia of the flap. If a powerful free radical scavenger is used, it may reduce the formation of free radical and improves the survival of flap. Thus, the present study purposed to examine whether the survival of flap can be enhanced by administering melatonin, which is known to be a powerful free radical scavenger a antioxidant molecule. Methods: We divided 40 Sprague-Dawley rats into 4 groups, 10 in each group. For the control group(n=10), we intraperitoneally injected only carrier solution once 30 minutes before the operation, and once a day for 7 days from the day of operation. Among the experimental groups, a group(n=10) was administered with dimethyl sulfoxide(DMSO), in another group(n=10), melatonin was intraperitoneally injected, and in the other(n=10) melatonin was intraperitoneally injected and applied topically(2 cc of 1% melatonin) to the operation site. Caudally based skin flaps measuring $3{\times}10cm^2$ were elevated on the mid-dorsum of the rats. and then repositioned. On the seventh postoperative day, the survival area of the flap was measured and tissues were examined under the light microscope. Results: The control group, the DMSO group, the melatonin administration group and the melatonin administration and application group showed the mean survival rates of $55.26{\pm}9.2%$, $70.29{\pm}7.47%$, $81.45{\pm}4.14%$ and $86.1{\pm}1.52%$, respectively, for $30cm^2$ of flap. Compared to the control group, the experimental groups showed a significantly high increase in survival area at significance level of 95%. Conclusion: In this study, the survival rate of flap was enhanced through the administration of melatonin after flap surgery. This suggests that melatonin not only functions as a powerful free radical scavenger and oxygen radical scavenger but also stabilizes and protects cells, and by doing so, enhances the survival of moderately injured ischemic sites in the distal end of flap.

• Applied Microscopy
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• 제28권1호
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• pp.39-48
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• 1998

The spermatozoa of bagrid catfish, Pseudobagrus fulvidraco are approximately $76{\mu}m$ in length, and a relatively simple and elongated cell composed of a spherical head, a short middle piece and a tail. The ultrastructure of spermatozoa of P. fulvidraco is characterized by the following features. The acrosome is absent as in most teleost. The round nucleus measuring about $1.67{\mu}m$ in length and diameter is depressed with a deep nuclear fossa. The nuclear fossa, the length of which is about three-fifths of the nuclear diameter, contains the proximal and distal contrioles. The two centrioles are oriented approximately $160^{\circ}$ to each other. The filamentous materials give rise to satellite appendages arranged tangentially from the triplets of the distal centriole and the doublets of the anterior end of the axoneme toward the nuclear envelope. The mitochondria are not fused and their number is 20 or more. They are arranged in two or three layers and two rings within the cytoplasmic collar and surround the axoneme. They are separated from the axoneme by the cytoplasmic canal. The axoneme is of the 9+2 microtubular pattern and has inner but no outer dynein arms. The two lateral fins are in the same plane with the two central microtubules, the doublets 3 and 8, which are ultrastructural characteristics of the sperm tail unlike other siluroids lacking the lateral fins.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• 제28권2호
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• pp.144-154
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• 2024

Backgrounds/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004-2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions: Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

• Advances in pediatric surgery
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• 제4권2호
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• pp.100-109
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• 1998

The anomalous pancreaticobiliary duct union (APBDU) might cause the formation of choledochal cyst and malignancies of hepatopancreaticobiliary system. The purpose of this study is to make an experimental animal model of APBDU similar to that of human. One to two-month-old Mongrel dogs (n=12) were divided into two groups; the control group (n=2) had a sham operation performed, and in the experimental group (n=10) the end of distal ' common bile duct (CBD) was anastomosed to the side of the dorsal pancreatic duct making APBDD. Serum was obtained for chemical analysis on the 10th postoperative day. The dogs were sacrificed at the 5th week (n=3), the 6th week (n=3), the 7th week (n=2), the 8th week (n=2) and the 6th month (n=2) after the experimental surgery. With sacrifice, operative cholangiogram was taken, and bile juice was obtained for chemistry and bacterial culture. The en-bloc specimens of the hepatopancreaticobiliary system were removed for microscopic examination. Serum and bile juice amylase levels were elevated in the experimental group(n=10), but not in the control group(n=2). Operative cholangiograms of control group revealed no evidence of bile duct dilatation.. On the other hand, the bile duct in the experimental group was markedly dilated without any evidence of stenosis at the anastomosis site (n=10). Histologic examination of the hepatopancreaticobiliary system in the experimental group resembled the findings of choledochal cyst in human. The APBDU of this animal model can produce bile duct dilatation by pancreaticobiliary reflux. We think that this animal model can be potentially promising for the research about the APBDU associated hepatopancreaticobiliary diseases.

• Phonetics and Speech Sciences
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• 제1권4호
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• pp.203-207
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• 2009

Electrically evoked compound action potentials (ECAP) have originated from the distal end of the auditory nerve. ECAP are characterized as the difference between the clearly large trough (N) and the following positive peak (P). N-wave occurs around $200-400\;{\mu}s$ after stimulus onset and P-wave at around $400-800\;{\mu}s$. Contrary to expectations, positive peaked ECAP (pp-ECAP) was dominated by a relatively large-amplitude positive following negative peak. pp-ECAP can be recorded from the sites on or near the surgically exposed nerve trunk in animal models and/or in cases of monophasic stimulation. This study will provide the causes of the appearance of pp-ECAP in cases of cochlear implant recipients using imaging studies and medical records and statistically analysis between N-P and P-N on the amplitude input-output function (amp-I/O) for the prediction of the possibilities of clinical tools. Thirteen children participated in the study and received a Cochlear CI-24RE (CA). ECAP was recorded using auto-NRT (Cochlear Ltd., Australia) at four to five weeks post surgery. pp-ECAP was measured from 36 electrodes and typical ECAP from 220 electrodes. There was no abnormality in the imaging study and operation finding in patients with typical ECAP. pp-ECAP was found at the inner ear anormaly and ossification in imaging study and gel-state inner ear fluid was observed in the operation finding. The amplitude of pp-ECAP increased depending on current intensities, but amp-I/O increase more gradually than in the case of typical ECAP (p=0.003). pp-ECAP is antidromic potential which can record from the inner ear anormaly and ossified cochlear. Amp-I/O also depends on current intensity as well typical ECAP. These results provide a useful tool for audiological evaluation for the spiral ganglion cell status to the value of pp-ECAP.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.12-17
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• 2001

Recovery of nerve injury is conditioned by various factors including physical state, injured site, cause of injury, and neurorrhaphy Many researchers have reported on regeneration of nerve using end to side neurorrhaphy. The purpose of this study was to examine regeneration of nerve in various conditioned side to side neurorrhaphy. Total of 25 male Sprague-Dawley rats weighing 220 to 250 gm were divided into five groups of five rats each. The group 1, sham group, composed of dissection only without nerve transaction. The group 2, control group, composed of nerve division only without neurorrhaphy or sural nerve graft. The group 3 composed of one segmental sural nerve graft between the tibial and peroneal nerve after division. Group 4 had two segment graft, and the group 5 with three segment graft, each segment being 6mm long and 5 mm apart. The side to side neurorrhaphy was performed between peroneal nerve and tibial nerve using segmental sural nerve graft in rats. We exposed the sciatic nerve, tibial nerve, peroneal nerve, and sural nerve on left side with prone position. The peroneal nerve was cut on the bifurcation site from tibial nerve and the side to side epineurial neurorrhaphy was performed between peroneal nerve and tibial nerve through 6 mm sural nerve segment graft with 11-0 nylon under operating microscope. The electromyography and the weight from ipsilateral tibialis anterior muscle was performed at one month after neurorrhaphy Peroneal and tibial nerve was examined at distal and proximal to the neurorrhaphy site by methylene blue stain under light microscope for histologic appearance. The number of nerve fibers were counted using the image analyzer. Statistically, both in electromyography and number of nerve fibers, the differences in values between the groups were significant.

• The Journal of the Korean bone and joint tumor society
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• 제12권1호
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• pp.83-88
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• 2006

Osteochondroma is a hyperplasic bony lesion caused by subperiosteal displacement of physeal cartilages, and the most common benign bone tumor. Osteochondromas rarely cause vascular complications, but when encountered, acute ischemia, phlebitis, and arterial puncture are the most common. They are caused by the mass effect or by the sharp end of the tumor. Deep vein thrombosis may be caused by impaired venous blood flow or a hypercoagulable blood state, but sometimes no predisposing cause can be found. We experienced a patient with deep vein thrombosis caused by the mass effect of an asymptomatic osteochondroma, and treated him successfully by excising the osteochondroma and performing a saphenous vein graft after resecting obstructed vein.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.391-395
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• 2012

Objective : Removal of the anterior clinoid process (ACP) is an essential process in the surgery of giant or complex aneurysms located near the proximal internal carotid artery or the distal basilar artery. An extradural clinoidectomy must be performed within the limits of the meningeal layers surrounding the ACP to prevent morbid complications. To identify the safest method of extradural exposure of the ACP, anatomical studies were done on cadaver heads. Methods : Anatomical dissections for extradural exposure of the ACP were performed on both sides of seven cadavers. Before dividing the frontotemporal dural fold (FTDF), we measured its length from the superomedial apex attached to the periorbita to the posterolateral apex which connects to the anterosuperior end of the cavernous sinus. Results : The average length of the FTDF on cadaver dissections was 7 mm on the right side and 7.14 mm on the left side. Cranial nerves were usually exposed when cutting FTDF more than 7 mm of the FTDF. Conclusion : The most delicate area in an extradural anterior clinoidectomy is the junction of the FTDF and the anterior triangular apex of the cavernous sinus. The FTDF must be cut from the anterior side of the triangle at the periorbital side rather than from the dural side. The length of the FTDF incision must not exceed 7 mm to avoid cranial nerve injury.

• Journal of Korean Orthopaedic Sports Medicine
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• 제8권1호
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• pp.56-59
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• 2009

Closed rupture of the extensor hallucis longus (EHL) tendon is uncommon and rarely reported. We present a Taekwondo player who had sustained a closed rupture of the EHL tendon after striking the other player's shin. He had practiced Taekwondo more than 6 hours a day for more than 6 years, including repetitive striking on the dorsum of the foot, which probably caused degeneration of the EHL tendon. The tendon ends could not be approximated directly, so reconstruction was performed with bisecting the distal tendon and combining the repair of the one end with an intercalary scar tissue and the other with tenodesis to the extensor hallucis brevis. He returned to the preoperative level of activity 6 months postoperatively with a satisfactory range of motion.