• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.544-550
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• 2016

Objective : Cerebral endothelial cells have unique biological features and are fascinating candidate cells for stroke therapy. Methods : In order to understand the molecular mechanisms of human cerebral endothelial cell (hCMEC/D3) transplantation in a rat stroke model, we performed proteomic analysis using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Protein expression was confirmed by quantitative real-time PCR and Western blot. Results : Several protein spots were identified by gel electrophoresis in the sham, cerebral ischemia (CI), and CI with hCMEC/D3 treatment cerebral ischemia with cell transplantation (CT) groups, and we identified 14 differentially expressed proteins in the CT group. Proteins involved in mitochondrial dysfunction (paraplegin matrix AAA peptidase subunit, SPG7), neuroinflammation (peroxiredoxin 6, PRDX6), and neuronal death (zinc finger protein 90, ZFP90) were markedly reduced in the CT group compared with the CI group. The expression of chloride intracellular channel 4 proteins involved in post-ischemic vasculogenesis was significantly decreased in the CI group but comparable to sham in the CT group. Conclusion : These results contribute to our understanding of the early phase processes that follow cerebral endothelial cell treatment in CI. Moreover, some of the identified proteins may present promising new targets for stroke therapy.

• Archives of Plastic Surgery
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• v.39 no.2
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• pp.138-142
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• 2012

Background : Electrical burns are one of the most devastating types of injuries, and can be characterized by the conduction of electric current through the deeper soft tissue such as vessels, nerves, muscles, and bones. For that reason, the extent of an electric burn is very frequently underestimated on initial impression. Methods : From July 1999 to June 2006, we performed 15 cases of toe tissue transfer for the reconstruction of finger defects caused by electrical burns. We performed preoperative range of motion exercise, early excision, and coverage of the digital defect with toe tissue transfer. Results : We obtained satisfactory results in both functional and aesthetic aspects in all 15 cases without specific complications. Static two-point discrimination results in the transferred toe cases ranged from 8 to 11 mm, with an average of 9.5 mm. The mean range of motion of the transferred toe was $20^{\circ}$ to $36^{\circ}$ in the distal interphalangeal joint, $16^{\circ}$ to $45^{\circ}$ in the proximal interphalangeal joint, and $15^{\circ}$ to $35^{\circ}$ in the metacarpophalangeal joint. All of the patients were relatively satisfied with the function and appearance of their new digits. Conclusions : The strategic management of electrical injury to the hands can be both challenging and complex. Because the optimal surgical method is free tissue transfer, maintenance of vascular integrity among various physiological changes works as a determining factor for the postoperative outcome following the reconstruction.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.829-835
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• 2011

Purpose: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. Methods: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. Results: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. Conclusion: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.409-412
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• 2007

Purpose: Percutaneous Kirschner wire fixation is common method for hand fracture. It is simple but has risk of ascending infection through the pin and bony injury by multiple drilling. Ascending infection through pin tract is mostly superficial and can be treated with antibiotics and aseptic dressing. This is a case review of subacute osteomyelitis on phalangeal bones after Kirschner wire fixation with literature review. Methods: A 40-years-old man with distal phalangeal fracture on right second finger is presented. He went to a local clinic and had percutaneous Kirschner wire fixation under local anesthesia. He was transferred to our hospital for ulcerative wound on DIP joint at 4 weeks after operation. Radiography showed osteolytic change around medulla of middle and distal phalanges, leading to diagnosis of a subacute osteomyelitis. We treated it with amputation at the level of shaft of middle phalanx. Results: The postoperative course was uneventful. We thought several possible reasons for osteomyelitis in our case. First, it could resulted from ascending infection through the wire. Second, it could be resulted from a bony burn by repeated drilling. And bony necrosis could be a consequence of arterial insufficiency caused by 2 pin insertion. Conclusion: We suggest that a precise pinning based on accurate anatomical understanding is required for a percutaneous Kirschner wire fixation. The frequency of drilling should be minimized. Careful observation and patient education for pin site care are essential.

• Journal of Haehwa Medicine
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• v.14 no.1
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• pp.51-57
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• 2005

Though the literature study on the urine therapy, we concluded as follows. It Almost use urine, healthy child's of under 10-12 age, and the gathering takes the middle part of urine. It Almost drinks fresh urine warmly. It drinks urine with Zingiber is Rhizoma Recens juice and Allii Radix or Sappan Lignum and Achyranthis Bidentatae Radix which is hwa-hyeol-geo-eo medicine in vomiting blood nosebleeding, with Allii Radix and Sojae Semen Praeparatum in a headache, with bile of pig in symptoms of shang han jue yin, with Zingiberis Rhizoma Recens juice Ginseng Radix's powder in doing the colon good or person have weak spleen and stomach as well as deficiency of qi with Bambusae Caulis in Liquamen or Zingiberis Rhizoma Recens juice in heat movement by deficiency of blood (eum-heo-hwa-dong) with Perillae Fructus, Mori Cortex and Adenophorae Radix which hwa-dam-ji-hae medicine and sparagi Radix, Liriopis Tuber Schizandrae Fructus which is bo-eum medicine in a cough by deficiency of blood(eum-heo-hae-su). Also it followed in condition and the honey little quantity alcoholic beverage it put in and with the urine it drinks it did. The case which the skin bursts Injury by biting. The eye comes to be red and smart in consequence of the fact that it swells, it pastes the warm urine in the wound region. In consequence of the fact that beriberi disease or to the case which is fed up the finger, it soaks the wound region in the urine. It was used in the external medical therapy which is various even on the thing outside which it drinks. It does not use or must use very prudently to person who has deficiency of gi and blood, weak stomach, not heat and fake heat.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.1
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• pp.19-28
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• 2011

More than 30,000 Wooden Slips were excavated in the Juyan region in 1930s and 1970s. These slips recorded military actions of Juyan Frontier Fortress during Han dynasty, which is about BC 100 ~ AD 30. On the slips, there are many disease names and symptoms mentioned. We focused on a certain disease name, namely, Shnaghan(傷寒; injured by cold), which is the main subject of Shangha-lun(傷寒論). Looking closely into these Juan Wooden Slips, we found many articles recording Shanghan, including related diseases and symptoms, such as Shanghan(傷汗; injured by sweat), headache, fever and chills, immobilization of limbs, unacceptance of foods. And there are another Shanghan-related symptoms, such as inflation of upper-abdomen(心腹支滿), pain of upper abdomen(心腹痛), strain of both armpits(兩胠葥急), inflation of chest(胸脇支滿), tightness and fear in the chest(煩滿). Although they have no direct relationship with Shanghan, there are many symptoms, including the external wounds of waist, finger, thigh, back, breast and head, abscess of leg and elbow, sore throat, itching, leucorrhea, powerlessness of hands and legs(手足癃), visceral injury(傷臟), tinnitus, cold, warm and heat. Because the Wooden Slips are very short, with some characters even missing, we can not confirm the detail of the disease and symptoms. In addition, we will report about the herbal medicines and other treatments, which are recorded on the slips, by further research.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.636-641
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• 2011

Purpose: There are multiple dependent variables commonly attributed to survival of replanted digits. The ischemia time is thought to be a clinically relevant factor. However, controversy exists as large hand centers have reported successful replant outcomes independent of ischemic time. In this study, we present a single institution experience on the effect of ischemia time on the survival of completely amputated digits. Methods: A retrospective review of a single institution experience was performed. This cohort included all comers who had suffered complete amputation of a digit (Zone 2-4) and underwent replantation from 2003 to 2009. Demographic information as well as injury mechanism, ischemic time, and replantation outcome were recorded for each patient. Chi-square was used to analyze the result. Results: Mean age was 35.5 years old (2-69). Mean replantation survival was 89.5% (37/317). Survival rates were 94, 88, and 88% in respective groups of 0~6, 6~12, of > 12 hours of ischemia time. In chi-square analysis, there was no difference with $p$ value of 0.257. No other independent patient factors showed statistically significant relationship to replant survival rate. In the group with longest ischemia time (12~18 hours) replant survival rate was 88% (37/42). Conclusion: Prolonged ischemia time is commonly believed to be a contributing factor for replant survival. However, our experience has shown that survival rate is uniform up to 18 hours of ischemia.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.31-37
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• 2011

Background: Carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) are thought to share a similar pathophysiology, compression of the median and plantar nerve by the carpal tunnel and flexor retinaculum. A few reports introduced the relationship between idiopathic CTS and TTS without definite evidence of coexistence. The current study was designed to analyze the electrophysiologic characteristics of combined idiopathic CTS and TTS by comparing with each idiopathic CTS or TTS. Methods: We retrospectively collected patients with combined idiopathic CTS and TTS (CTS-TTS group) from June 2001 to February 2009. Patients with each idiopathic CTS or TTS were collected as controls. Electrophysiologic data of median and plantar nerves were compared between CTS-TTS group and controls. Results: CTS-TTS group was composed of 31 patients. Control group of each CTS or TTS were 50 CTS and 49 TTS patients. In comparison of median nerve conduction study between CTS-TTS group and CTS control group, decreased compound muscle action potential amplitude (p<0.001), decreased median sensory nerve action potential amplitude (p<0.001) and sensory nerve conduction velocity at finger stimulation (p=0.013) were prominent in CTS-TTS group. Decreased medial plantar sensory nerve action potential amplitude (p=0.034) was indicated when CTS-TTS groups and TTS control group were compared. Conclusions: If the electrophysiology study of patients with CTS or TTS was suggestive of severe degree of nerve injury, concerns about the possibility of combined CTS and TTS would be helpful.