• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.30.1-30.8
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• 2019

Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.49-54
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• 2009

Purpose: Inevitably, Maxillary structural defect follows maxillary cancer extirpation. Maxillary reconstruction is over every surgeon's head. Every physician tried to overcome limited donor site of craniofacial defect. We considered to suggest optimal method of inferior orbital wall defect in functional point as well as esthetic point. Methods: We performed wide excision of maxilla and vascularized partial thickness calvarial bone flap to reconstruct the defect from cancer extirpation in three cases. We select ipsilateral superficial temporal artery, vein and outer cortex of parietal bone flap as donor. And we applied bone flap as inferior orbital wall structure. The bony surface was wrapped with fascia to prevent direct contact between orbital contents and rough bony flap surface. Computed tomography image was checked during follolw up period. Results: We can observe these patients for over two years. In all three cases, We can get fair inferior orbital wall structure. Even though they got radiation therapy, there was no limitation of extraocular movements, no diplopia. no enophthalmos. Also there was minimal donor site morbidity. Conclusion: We suggest vascularized calvarial bone flap is practically excellent strategy for inferior orbital wall reconstruction.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.61-77
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• 2003

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. Bone graft & guided tissue are being used for the regeneration of destroyed periodontium these days. Non-resorbable membranes were used for Guided tissue regeneration in early days, however more researches are focused on resorbable membranes these days. The aim of this study is to evaluate the osteogenesis of paradioxanone membrane on the calvarial critical size defect in Sprague Dawley rats. An 8 mm diameter surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into three groups: Untreated control group, Biomesh(R) group and paradioxanone group. The animals were sacrificed at 4, 8 and 12 weeks after surgical procedure. The specimens were examined by histologic, histomorphometric analyses. The results are as follows: 1. In histological view on Biomesh(R), no visible signs of resorption was observed at 4 weeks but progressive resorption was observed at 8 weeks through 12 weeks. Paradioxanone membrane expanded at 4 weeks, and rapid resorption was observed at 8 weeks. In both the membranes, inflammatory cells were observed around them. Inflammatory cells decreased with time but were still present at 12 weeks. More inflammatory cells were observed in paradioxanone membranes than in Biomesh(R) membrane. 2. The area of newly formed bone in the defects were 0.001${\pm}$0.001, 0.006${\pm}$0.005, 0.002${\pm}$0.003 at the 4 weeks, 0.021${\pm}$0.020, 0.133${\pm}$0.073, 0.118${\pm}$0.070 at the 8 weeks and 0.163${\pm}$0.067, 0.500${\pm}$0.197, 0.487${\pm}$0.214 at the 12 weeks in the control group, Biomesh(R) group and experimental group respectively. Compared to the control group, Biomesh(R) group displayed significant differences at 4,8, and 12 weeks and the paradioxanone group at 8 and 12 weeks.(P<0.05)

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.6
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• pp.544-549
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• 2009

Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

• KSBB Journal
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• v.28 no.6
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• pp.372-379
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• 2013

This study was to investigate the chemical properties and nitrite scavenging and acetylcholinesterase inhibitory activities from Salicornia herbaciea seed. The lactic acid content of seed was about 2.0 fold higher than that of stem. Among various free sugars, the maximum fructose of seed, glucose of stem, and mannose contents of root were obtained, 176.3, 125.6, and 112.8 mg/100g, respectively. The maximum leucine content of seed among the essential amino acid was obtained, 853.7 mg/100g, which was about 3.0 or 6.0 folds higher than that of root or stem. In the case of glutamic acid of seed, it was 2,388.7 mg/100g, which was 5.6 or 9.8 folds higher han that of root or stem. The ratio of essential amino acid and total amino acid of seed was 30.14%. The ${\gamma}$-aminobutyric acid contents of seed, stem, and root were 43.87, 23.88, and 27.8 mg/100g, respectively. The catechin content of seed was an order of epigallocatechin (723.2 mg/100g) > epigallocatechingallate (654.3 mg/100g) > epicatechin (443.5 mg/100g) > gallocatechin (314.1 mg/100g). Especially, the non-gallated catechins content was about 2.0 folds higher than that of gallated catechins content. The nitrite scavenging activity of seed increased from 38.7 to 65.9% when the hot-water extract content of seed at pH 1.2 increased from 1.0 to 5.0 mg/mL. However, it was decreased to 25.7% at pH 6. The acetylcholinesterase inhibitory activity of seed was increased from 13.2 to 44.6% when the extract content increased from 20 to 100 mg/mL. These results show that S. herbaciea seed has a good potential to be used as a source of material or additive in cosmetics, food, and drug compositions.

• Journal of Korean Medical Ki-Gong Academy
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• v.11 no.1
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• pp.80-116
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• 2009

It studies into viewpoints of 7 doctors of Wenbing studies on macula. The results concerning characteristics, remedy and prevention of macula are as follows; Macule does not protrude on the surface of skin and does not have any color change for external stimulus, but rash out on the surface and becomes white when pushed. It becomes macule when the blood leaks beneath skin as stomach-heat of yangming enters into blood system and damages it. On the other hand, when heat enters lung meridian, penetrates beneath the skin and congeals inside the vessel, it becomes rash. When you combine symptoms of body and pulse with numbers, color, shape and distribution status of macula, you can diagnose the depth of rash, seriousness, the possibility of treatment and prognosis of macula. The remedy for macule consists of cooling heat of yaming, removing heat from the blood and relieving feverish rash, and the one for rash consists of facilitating meridian with aroma, expelling pathogenic factors from muscles with drugs of pungent flavor and cool nature and clearing away heat from the blood systems. It relieves the inhibited functional activities of lung-Ki, and helps extermination of rash as well as clearing heat of the vessel. Also, it is the most important to preserve resin of stomach for every treatment. It is good to avoid expelling pathogenic factors with drugs of pungent flavor and warm nature, raising drugs and invigorating drugs during treating macula. Moreover, the patients should not over dose cold-natured drugs and purgative therapy. There are common clinical symptoms of macula in advance, so right recognition of symptoms can contribute to prevention of macula.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.356-366
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• 2012

Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

• Journal of Mushroom
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• v.13 no.3
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• pp.192-198
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• 2015

This study was performed in order to analyze the fibrinolytic, thrombin inhibitory, anti-oxidative, acetylcholinesterase inhibitory, and immuno-enhancing activities of the water extract and solvent fractions isolated from Grifola frondosa. Fibrinolytic activity was analyzed using the fibrin plate method, and thrombin inhibitory activity was assayed using the substrate H-D-Phe-piparg- pna. Anti-oxidative activity was estimated using the DPPH assay, and AChE inhibitory activity was measured using the spectrophotometric method. Immuno-enhancing activity was examined using the nitric oxide (NO) production in RAW 264.7 macrophage cells. Cell viability was determined using the MTS assay. Fibrinolytic activities were the highest in water extract (1.55 plasmin units/mL) followed by water fraction (0.85 plasmin units/mL). The thrombin inhibitory activities of the water and ethyl acetate fractions were determined to be 76.43% and 72.59%, respectively. The acetylcholinesterase inhibitory activities of chloroform and hexane fractions exhibited values of 95.14% and 94.74%, respectively. The butanol fraction showed the highest anti-oxidative activity at 94.47%. Anti-proliferating activity against Raw 264.7 cells showed no cytotoxicity. The production of NO in Raw 264.7 cells increased up to 2-fold by adding the water fraction compared to the untreated control. These results suggest that Grifola frondosa may serve as a useful functional food for the enhancement of immune function and the prevention and therapy of cardiovascular diseases.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.50-57
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• 2014

Objectives: The purpose of this study was to examine whether Temporomandibular Joint Balance Appliance-Golf (TBA-G) can improve postural control ability of healthy adults. Methods: Twenty participants (10 male, 10 female) aged 20 to 39 years were involved. Postural control ability of all participants was assessed before and after applying TBA-G with Balance $Master^{(R)}$ system. Modified clinical test sensory interaction on balance (mCTSIB), unilateral stance, weight bearing and rhythmic weight shift were used to evaluate postural control ability. Results: After applying TBA-G, mCTSIB on a firm plate with eyes open increased from 0.2 to 0.23 (p<0.05) but directional control was improved in slow and moderate velocity of front/back rhythmic weight shift test (P<0.05). In two cases with postural imbalance, most of the postural control measures improved after applying TBA-G. Conclusions: The results suggest that TBA-G could improve balance control ability. A larger controlled trial is needed to determine more accurately the effect of TBA-G on balance control ability.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.18-25
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• 2011

Purpose: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. Materials and Methods: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. Result: The active range of motion for a group without interphalangeal joint fixation was measured $49.0^{\circ}$ on average, while $28.6^{\circ}$ was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured $52.0^{\circ}$ and $55.0^{\circ}$ on average for a group without and with interphalangeal fixation respectively. Conclusion: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.