• Archives of Plastic Surgery
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• v.32 no.1
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• pp.124-130
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• 2005

In the microsurgical era, replantation with microvascular anastomosis is considered as the most superior method in aspects of texture, color, shape in case of nose amputation. There are some reported cases of replantation in nose amputation historically, but most of them are composite graft cases rather than microvascular anastomosis. Only a few cases of successful nasal replantation with microvascular anastomosis have been reported due to the reason that the size of vessels is usually very small and identifying suitable vessels for anastomosis is difficult. Microanastomosis of artery and microanastomosis of vein are ideal in replantation, but identifying suitable veins is often difficult. Without venous anastomosis, resolving the venous congestion remains to be a problem. We can carry out arteriovenous shunt if we can find two arteries in amputee. However, the smaller the size of amputee is, the more difficult it is to find two arteries. Instead of arteriovenous shunt, we can try external venous drainage(frequently swab, pin-prick, stab incision, IV or local heparin injection, dropping, apply of heparin-soaked gauze, use of medical leech). Here, we present three cases of replantation with microscopical arterial anastomosis (one angular artery, two dorsal nasal arteries) and external venous drainage (stab incision, application of medical leech and heparin-soaked gauze) even though the size of amputee may be as small as $1.5{\times}1.0cm$. In all cases, surgical outcomes were excellent in cosmetic and functional aspects. This report describes successful replantation by microvasular anastomosis in case that suitable veins are not found.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• 유체기계공업학회:학술대회논문집
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• 2004.12a
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• pp.289-296
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• 2004

The present study has been performed to investigate the influences of rectangular fins on heat transfer in an impingement/effusion cooling system with crossflow. To simulate the impingement/effusion cooling system with initial crossflow, two perforated plates are placed in parallel and staggered arrangements with a gap distance of 2 times of the hole diameter. The crossflow passes between the plates, and various rectangular fins are installed on the plates. Reynolds number based on the hole diameter is fixed to 10,000 and the flow rate of crossflow is changed from 0.5 to 1.5 times of that of the impinging jet. A naphthalene sublimation method is used to obtain the heat/mass transfer coefficients on the effusion plate. Also to analyze the flow characteristics, a numerical calculation is performed. When rectangular fins are installed, the flow and heat transfer pattern is changed greatly from case without fins. In the injection hole region, the jet impinges on effusion plate without deflection and wall jet spreads symmetrically. In the effusion region, the crossflow accelerates due to the decrease of cross-sectional area in the channel. Local heat/mass transfer coefficients are enhanced significantly compared to case without fins. As the blowing ratio increases, the effect of fins against the crossflow becomes more significant and then the higher average heat/mass transfer coefficients are obtained than the case without fins.

• YAKHAK HOEJI
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• v.53 no.6
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• pp.328-333
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• 2009

Contrast media are substances that are used to enhance the contrast of structures or fluids within the body in medical imaging. Those are commonly used to enhance the visibility of blood vessels and the gastrointestinal tract. The aim of this study is to evaluate patients who got injected iopamidol, developed as one of contrast medium regarding changes in cardiovascular system and especially, adverse drug reactions. This study were performed on randomly selected a total of 51 patients (range of 15~85 years old) who got injected contrast medium, Iopamidol at a P hospital in Gyeonggi province from September 22nd, 2008 to January 24th, 2009. Data were collected by questionnaire though person to person. We analyzed the data by SPSS (Version 12. for windows). Methods of analysis were frequency and cross analysis. In results, 19.6% (n=10) were founded for adverse drug reactions of contrast medium. 25.0% (n=4) of 10 patients who had adverse drug reactions of contrast medium had took abdomen contrast test. 2 patients of those took contrast test for chest. Also, 3.9% (n=2) patients felt vomiting and nausea after injection of contrast medium. In conclusion, 19.6% patients experienced adverse drug reaction of contrast medium. Therefore, when taking radiation test, we should make efforts to minimize adverse drug reactions to achieve suitable and effective treatment.

• The Journal of Korean Medicine
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• v.19 no.2
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• pp.485-501
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• 1998

Cortex Mori (Moros alba L.), the root bark of mulberry tree has been used as an autiphlogistic, diuretic and expectorant in herval medicine. Recently, a few papers reported that phenolic extract of Cortex Mori had the hypotensive, hypoglycemic, antiviral and anticancer effects, and hot water extract of Cortex Mori(CM) had inhibitory effect on the degranulation and histamine release from activated mast cells. These previous studies suggest a possibility that CM has an antidotal activity against inflammation which was mediated mainly by macrophage-secreting inflammatory factors. This study was performed to evaluate the influences of CM on carrageenan-induced edema in vivo and release of inflammatory mediators such as NO, TNF and IL-1 by macrophages stimulated with LPS or $IFN-{\gamma}$ in vitro. Subcutaneous injections of carrageenan into the mouse paw rapidly induced local edema by increasing vascular permeability, but single intraperitoneal injection of CM extract at 30 minutes before carrageenan suppressed the development of edema. NO and TNF production from macrophage stimulated by LPS or $IFN-{\gamma}$ were significantly suppressed, especially TNF secretion by up to 3-4 folds. LPS stimulated IL-1 production was also inhibited, but not significantly. Cell viability assay verified that the inhibition was not due to general cell toxicity. These results suggest that reduction of NO, TNF and IL-1 production may be one of the means by which CM prevent inflammation associated diseases.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.91-93
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• 2008

De Quervain's disease is a stenosing tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis; it can be considered a work-related disease, since it frequently is associated with highly repetitive movements in jobs using the hands. The usual sign and symptom of de Quervain's diseases are positive Finkelstein's sign and pain and tenderness around the radial styloid process. The majority of de Quervain's disease has a good results to conservative treatment, but surgery can be performed in case of recurrence or pain last more than 6 months without improvement in spite of conservative treatment. We diagnosed a patient with atypical de Quervain's disease by ultrasonography, treated by local steroid injection and pain was relieved. We report a case of atypical de Quervain's disease evaluated by ultrasonography with brief of literatures.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.219-228
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• 2009

Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.

• YAKHAK HOEJI
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• v.49 no.2
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• pp.140-146
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• 2005

Candida albicans, a polymorphic fungus, causes systemic and local infections. Recent reports show that the fungus is a main etiological agent for the arthritis. For trea tment, antifungal drugs and/or rheumatoid drugs are used, but resistance and side effects limit application of the drugs. In search of new sources for treatment of the fungal arthritis, we choose Egb 761 (extract of Ginkgo leaves 761), one of the most popular over-the-counter herbal medicines. The Egb 761 contains two major ingredients such as terpene and flavonoid. In the present study, we examined if the terpene portion of Egb 761 had anti-inflammatory activity against C.albicans-caused arthritis. The terpene was extracted with combination of methanol and water from the Egb 761, followed by gel-permeation chromatography. Presence of terpene was determined by the Salkowski colorimetric method and HPLC analysis. For an animal model of inflammation induction, mice were given an emulsion form of C.albicans cell wall mixed with Complete Freund's Adjuvant (CFA) by footpad-injection. Results showed that intraperitoneal administration of the water-soluble portion that contained terpene and flavonoid reduced the inflammation. Whereas the terpene had anti-inflammatory activity, flavonoid portion had no such activity, For determination of possible mechanism of the activity, the terpene seemed to be suppression of nitric oxide (NO) production from LPS-treated macrophages. Taken together the Ginkgo terpene may have anti-inflammatory effect against C.albicans-caused arthritis, possibly by blocking NO production.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.106-111
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• 2008

Background: Chronic pain after thoracotomy has been recently reproduced in a rat model that allows investigating the effect of potentially beneficial drugs that might reduce the incidence of allodynia or alleviate pain. Local anesthetics produce antinociception in normal animals and alleviate mechanical allodynia in animals with nerve injury although their mechanisms of action may differ in these situations. Our purpose of this study was to test whether the preoperative intercostal nerve block of bupivacaine could prevent the development of allodynia in a rat model of chronic postthoracotomy pain. Methods: All male Sprague-Dawley rats were anesthetized and the right 4th and 5th ribs were exposed surgically. The pleura were opened between the ribs to which a retractor was placed and was opened 10 mm in width. Retraction was maintained for one hour. Total 1 mg of 0.5% bupivacaine was injected at the intercostal nerves before (n = 17) or after (n = 16) surgery. A control group (n = 25) that underwent rib retraction did not receive any drug. Rats were tested for mechanical allodynia using calibrated von Frey filaments applied around the incision site during the three weeks following surgery. Results: The incidence of development of mechanical allodynia in the group that received intercostal injection with bupivacaine before surgery was significantly lower than that in the control group (P < 0.05). Conclusions: Preoperative intercostal nerves block around the surgical incision before thoracotomy may decrease the incidence of postthoracotomy pain syndrome.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.126-132
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• 2017

Background: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. Methods: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%-75%, Group C: 25%-50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. Results: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). Conclusions: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.