• Journal of Veterinary Science
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• v.22 no.2
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• pp.22.1-22.9
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• 2021

Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.254-259
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• 2018

Background: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences. Methods: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications. Results: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft. Conclusion: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.

• Journal of Veterinary Clinics
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• v.36 no.1
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• pp.88-92
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• 2019

A 6-month-old male thoroughbred foal with melting ulcer after left eye trauma was referred to Equine Hospital of Jeju National University. The left eye did not respond to the menace reflex test. Bacteria were not observed on corneal smear and culture test, and fluorescein staining revealed corneal injury. Subpalpebral Lavage (SPL) catheter was installed through the upper left eyelid. And the antibiotics, mydriatic and antifungal agents were administered using SPL. In addition, temporary tarsorrhaphy was performed and a hard cup hood was applied. After 2 weeks, the temporary tarsorrhaphy was removed and severe corneal neovascularization was found. On the 39th day of treatment, the left eye was responding to the menace reflex test and granular tissue formation was confirmed in the ulcer area. During the 2 months follow-up, we found that the granulation tissues decreased significantly. This case report describes a successful recovery of severe melting ulcers in a foal by intensive treatment.

• (The) Research of the performance art and culture
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• no.18
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• pp.223-255
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• 2009

This paper deals with the tradition and identity of physical expression(${\bar{a}}{\dot{n}}gika$ abhinaya) system in Indian traditional theatre and dance. The ${\bar{a}}{\dot{n}}gika$ abhinaya of Indian dance and theatre has been stylized through long terms and thereby defines their identity and peculiarity by its highly stylized expression techniques while following dramatic way($n{\bar{a}}tya$-dharmi). The ${\bar{a}}{\dot{n}}gika$ abhinaya is said to had been derived from the ritualistic practice of ancient Vedic period(B.C. 15th-B.C. 5th c.), which is most clearly exemplified in hand gesture(hasta mudra). In $N{\bar{a}}tya$ ${\acute{S}}astra$, ${\bar{a}}{\dot{n}}gika$ abhinaya is explained in detail. It is classified broadly into facial expression(mukhaja abhinaya), gesture expression(śārīra abhinaya), movement expression($cest{\bar{a}}krita$ abhinaya). Further, $N{\bar{a}}tya$ ${\acute{S}}astra$ divides their various usages by parts which include head, glance, eyes, nose, eyelid, cheek, lower lip, chin, mouth, hand, chest, waist, belly, hip. thigh, claf, foot. Besides, it explains diverse ways of foot movement($c{\bar{a}}ri$), standing poses(sthana), gait(gati) and their combined movements(mandala). Many forms of Indian traditional theatre and dance basically follows the rule of ${\bar{a}}{\dot{n}}gika$ abhinaya proposed in $N{\bar{a}}tya$ ${\acute{S}}astra$, which identifies their unique characteristics.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.357-362
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• 2020

Background: Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. Methods: We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. Results: We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. Conclusion: In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient's advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

• Journal of Veterinary Science
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• v.24 no.4
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• pp.59.1-59.13
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• 2023

Background: Rocuronium bromide has been evaluated as a mydriatic agent in birds, but the species applied were limited and the dose and effect were variable. Objective: This study aims to evaluate the efficacy of topical rocuronium bromide as mydriatics in 4 species according to horizontal palpebral fissure length: Feral pigeon (Columba livia), Common kestrel (Falco tinnunculus), Northern boobook (Ninox japonica), and Eurasian eagle owl (Bubo bubo). Methods: A total of 32 birds (8 for each species) were included as pre-releasing examination. Rocuronium bromide was instilled in one randomly selected eye of each bird based on palpebral fissure length criteria (0.5 mg/50 µL for pigeons, 1 mg/100 µL for kestrels and boobook owls, and 2 mg/200 µL for eagle owls). The contralateral eye was used as control and treated with normal saline. After instillation of the drug, pupil diameter, pupillary light reflex, intraocular pressure, heart rate, and respiratory rate were evaluated at 10 min intervals up to 180 min and at 30 min intervals up to 360 min. Results: Statistically significant mydriasis was obtained in all birds (p < 0.001). However, in boobook and eagle owls, marked mydriasis persisted until 360 min. Side effects including corneal erosion and lower eyelid paralysis were common, which was observed in 26/32 birds. Blepharospasm was also noted during this study. No systemic adverse signs were observed. Conclusions: Rocuronium bromide could be a good mydriatics option for 4 species of birds, however, further studies are needed to find lowest effective dose to reduce drug-related side effects.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.446-451
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• 2023

Background Elderly patients often have complications of blepharoptosis surgery that can result in the appearance or exacerbation of superficial punctate keratopathy (SPK). However, postoperative changes to SPK status have not been previously reported. We used subjective assessment of symptoms and measurement of SPK scale classification to investigate the safety and efficacy of blepharoptosis surgery in elderly patients. Methods Included in this prospective study were 22 patients (44 eyes) with bilateral blepharoptosis that underwent surgery. Patients comprised 8 males and 14 females with a mean (±standard deviation) age of 75.7 ± 8.2 years (range: 61-89). Blepharoptosis surgery consisted of transcutaneous levator advancement and blepharoplasty including resection of soft tissue (skin, subcutaneous tissue, and the orbicularis oculi muscle). Margin reflex distance-1 (MRD-1) measurement, a questionnaire survey of symptoms and SPK scale classification, was administered preoperatively and 3 months postoperatively for evaluation. Results The median MRD-1 was 1 mm preoperatively and 2.5 mm postoperatively, representing a significant postoperative improvement. SPK area and density scores were found to increase when the MRD-1 increase was more than 2.5 mm with surgery. All 10 items on the questionnaire tended have increased scores after surgery, and significant differences were observed in 7 items (poor visibility, ocular fatigue, heavy eyelid, foreign body sensation, difficulty in focusing, headaches, and stiff shoulders). Conclusion Blepharoptosis surgery was found to be a safe and effective way to maintain the increase in MRD-1 within 2.0 mm. Despite the benefits, surgeons must nonetheless be aware that blepharoptosis surgery is a delicate procedure in elderly people.

• Archives of Craniofacial Surgery
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• v.24 no.5
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• pp.218-222
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• 2023

Background: Botulinum toxin is a neurotoxic substance with a wide range of uses, from the treatment of musculoskeletal spasms to anti-aging regimens by improving wrinkles. Split-face studies in which drugs are injected in the right and left sides of the faces have been actively conducted in botulinum toxin studies. In this study, we aimed to investigate the reliability of a split-face study for determining the effectiveness of botulinum toxin based on eyebrow height and movement, and electromyography results. Methods: Thirty-one women aged 35 to 55 years were included in the study. Eyebrow height was measured as the distance from the eyebrows to the upper eyelid margin on the primary gaze, and eyebrow movement was measured as the distance when the forehead was wrinkled for 5 seconds. A noninvasive method was used for electromyography of the frontalis muscles. Results: No statistically significant differences in right and left eyebrow heights and movements, and electromyography findings (p= 0.256, p= 1.000, and p= 0.978, respectively) were found. Pearson correlation analysis showed that electromyography muscle activity is positively associated with eyebrow movement, respectively (p< 0.001). Conclusion: We advocate the reliability of split-face study and the usefulness of electromyography of frontalis muscle in forehead rejuvenation research.

• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.429-443
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• 2024

Background: The study reports the effect of Korean medicine treatment on a patient with left facial palsy caused by Wegener's granulomatosis. Case information: The patient was receiving steroid treatment for facial palsy and was hospitalized for 21 days. He received acupuncture, electroacupuncture, bee venom pharmacopuncture, and moxibustion treatment along with Ssanghwa-tang and Cheongansohabwon herbal medicine treatment. During hospitalization, the Sunnybrook facial grading scale, House-Brackmann scale and length of time for the eye to completely close were evaluated at 11/16, 11/21, 11/27, 12/1, and 12/6. Post treatment, the degree of the movement in the left eyelid was improved, it took less time for the eye to close completely, the movement of the forehead wrinkle muscles improved, but that of the facial muscles under the eyes and left orbicularis oculi muscle showed little improvement. Conclusion: Korean medicine treatment for facial palsy caused by Wegener's Granulomatosis helps restore mobility of the forehead and orbicularis oculi muscles.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.87-95
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• 2015

Purpose : This study presents the usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit. Materials and Methods : We accomplished IMRT treatment plan similar with a real one through the computed treatment planning system after CT simulation using human phantom. For the secondary shield, we used Pb plate (thickness 3mm, diameter 25mm) and 3 mm tungsten eye-shield block. And we compared lens dose using OSLD between on TPS and on simulation. Also, we irradiated 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$) on a 5cm acrylic phantom using the secondary shielding material of same condition, 3mm Pb and tungsten eye-shield block. And we carried out the same experiment using 8cm Pb block to limit effect of leakage & transmitted radiation out of irradiation field. We attached OSLD with a 1cm away from the field at the side of phantom and applied a 3mm bolus equivalent to the thickness of eyelid. Results : Using human phantom, the Lens dose on IMRT treatment plan is 315.9cGy and the real measurement value is 216.7cGy. And after secondary shield using 3mm Pb plate and tungsten eye-shield block, each lens dose is 234.3, 224.1 cGy. The result of a experiment using acrylic phantom, each value is 5.24, 5.42 and 5.39 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Applying O.S.B out of the field, each value is 1.79, 2.00 and 2.02 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Conclusion : When secondary shielding material is used to protect critical organ while irradiating photon, high atomic number material (like metal) that is near by critical organ can be cause of dose increase according to treatment region and beam direction because head leakage and collimator & MLC transmitted radiation are exist even if it's out of the field. The attempt of secondary shield for the decrease of exposure dose was meaningful, but untested attempt can have a reverse effect. So, a preliminary inspection through Q.A must be necessary.