• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.294-301
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• 2013

Purpose: To report the clinical outcomes and complications of flexor hallucis longus (FHL) tendoscopy using 3 portals. Materials and Methods: Between January 2012 and April 2013, 10 patients (10 ankles) received tendoscopic surgery for the treatment of FHL tenosynovitis. Patients complaining of pain and tenderness along the course of FHL despite over 6 months of conservative treatments were indicated for surgery. The mean age was 41.7 years (range: 18-57) and the follow up period was 12.7 months (range: 6-20). Tendoscopy was performed using posteromedial, posterolateral, and plantar portals. Clinical evaluations included preoperative and postoperative visual analogue scale (VAS), American orthopaedic foot and ankle society (AOFAS) score, and patients' satisfaction. Results: Tendoscopic findings included tenosynovitis in 10 cases, degenerated vinculae in 6 cases, stenosis of the tendon at its entrance into the fibro-osseous tunnel in 5 cases, and degenerative partial tendon tear in 3 cases. Two cases had associated symptomatic os trigonum and 3 cases had posterior ankle impingement syndrome. Preoperative pain decreased from median VAS 6 (range: 4-10) to 2.1 (range: 1-5) at the last follow up and AOFAS score improved from 50.1 (range: 36-63) to 82.1 (range: 61-89) (p<0.05). Nine patients were satisfied or very satisfied with the outcome. Injury of the lateral plantar nerve occurred in one case. Conclusion: FHL tendoscopy using 3 portals is a feasible and useful minimal invasive surgical technique for the management of FHL tenosynovitis.

• The Korean Journal of Physiology and Pharmacology
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• v.15 no.5
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• pp.307-312
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• 2011

It has been rereported that axons which display 5-hydroxytryptamine (5-HT) immunoreactivity are abundant in the pancreas and the majority of serotonergic axons terminate within intrapancreatic ganglia, islet and acini. This histological result strongly suggests that intrapancreatic serotonergic nerves could affect to the pancreatic endocrine and exocrine secretion. Thus, this study was aimed to investigate whether intrapancreatic serotonergic nerves could affect pancreatic exocrine secretion and an action mechanism of the intrapancreatic serotonergic nerves. The rats were anesthetized with a single injection of urethane. The median line and the abdominal aorta was carefully dissected and cannulated with PE-50 tubing just above the celiac artery, and then tightly ligated just below the superior mesenteric artery. The pancreatic duct was also cannulated with Tygon microbore tubing. With the addition of serotonin, pancreatic volume flow and amylase output were significantly inhibited electrical field stimulation (EFS). On the other hand, pancreatic volume flow and amylase output were significantly elevated in EFS with the addition of spiperone. EFS application, however, pancreatic volume flow and amylase output had no significant change in cholecystokinin (CCK) alone when serotonin was applied under a 5.6 mM glucose background. Pancreatic volume flow and amylase output under 18 mM glucose background were significantly elevated in CCK plus serotonin than in CCK alone. These data suggest that intrapancreatic serotonergic nerves play an inhibitory role in pancreatic exocrine secretion and an important role in the insulin action or release.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.663-668
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• 2011

Purpose: A modified free thenar flap was designed for coverage of volar finger defect with constant innervation using the palmar cutaneous branch of the median nerve. After clinical application of this flap, sensory results were evaluated in 6 cases. Methods: Patients were selected who have volar soft tissue defect with or without fingertip defect. The six cases of the innervated free thenar flap were performed since September 2009, and sensory outcomes were evaluated by the Semmes-Weinstein monofilament and two-point discriminator at four and half month after the surgery. Results: The Semmes-Weinstein Monofilament test revealed 3 cases showed 2.83, 1 case showed 3.61, 1 case showed 4.31 and 1 case showed 4.56. The static two-point discrimination test revealed 1 case showed 4 mm, 1 case showed 6 mm, 2 cases showed 9 mm, and 2 cases showed over 15 mm. The moving two-point discrimination test revealed 1 case showed 3 mm, 1 case showed 4 mm, 1 case showed 5 mm, 1 case showed 7 mm, and 2 cases showed over 15 mm. The donor sites showed no significant limitation of the thumb and neuroma formation. Conclusion: The innervated free thenar flap showed good sensory outcomes as a sensate free flap in a short time after surgery. It can be an option for coverage of volar finger defects that requires sensation.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.974-982
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• 2019

Objective: Modern medicine offers no efficient way to clear colonization by vancomycin-resistant enterococci (VRE). However, VRE decolonization needs to be cleared as soon as possible to prevent VRE transmission. This study reports six cases in which the duration of vancomycin resistant enterococcus (VRE) colonization was reduced by Bojungikki-tang-gami. Methods: Six inpatients with VRE colonization were administered Bojungikki-tang-gami and continuously followed up with cultures. After three negative stool cultures, the patients were declared cleared of VRE colonization. We recorded the duration of VRE colonization. Results: The duration of VRE colonization in the six patients was a mean of 58 days and a median of 45 days. This was shorter than the duration reported in most previous studies. No side effects were noted. Conclusions: The findings of this study suggest that Bojungikki-tang-gami might be effective in shortening the duration of VRE colonization.

• The Korean Journal of Pain
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• v.32 no.3
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• pp.206-214
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• 2019

Background: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. Methods: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). Results: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB ($33.0{\mu}g$; interquartile range [IQR], $27.0-69.5{\mu}g$) than in the control group ($92.8{\mu}g$; IQR, $40.0-155.0{\mu}g$) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). Conclusions: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.313-318
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• 2018

Although nerve injury is the most common complication of pneumatic tourniquets, it is said to be rare, with few case reports. We describe two cases of paralysis after upper extremity surgery to highlight this risk. Ulnar, median and radial neuropathies were diagnosed after surgery was performed on a man for left hand reconstruction, presumably due to a prolonged total inflation time of 14 hours despite conventional break times. A woman who received surgery for a crushed hand presented with radial neuropathy, the most probable cause being malfunction and automatic inflation of the tourniquet. These cases illustrate the diversity of tourniquet paralysis, with symptomatic progress not necessarily following electromyography results. The considerable discomfort to patients warrants careful use of tourniquets for neuropathy prevention.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.73-89
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• 2021

Objectives We conducted an online survey to understand the current status of Korean Medicine clinical practice related to carpal tunnel syndrome (CTS) to develop the CTS Korean Medicine Clinical Practice Guidelines (CPG). Methods A thoroughly reviewed questionnaire was distributed by e-mail to 21,719 Korean Medicine doctors between March 26 and April 30, 2021. All raw data were arranged and analyzed systematically. Results The response rate among the doctors was 4%. Of the respondents, 82.1% responded that it is necessary to develop the CTS Korean Medicine CPG. We also obtained data related to the specific diagnosis, treatment, and prognosis management methods used at various treatment sites for patients with CTS. Conclusions This online survey will be helpful in developing the CTS CPG, which will contribute to the standardization of guidelines and improvements in the reliability of Korean Medicine. Our findings will provide valuable data and resources for future clinical studies on CTS.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.315-321
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• 2021

Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 ± 1.3 and 6.7 ± 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 ± 1.1 and 6.1 ± 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 ± 0.9 and 5.1 ± 1.0, respectively. The ESWT group had a MHQ score of 54.4 ± 7.7 before treatment and 73.3 ± 6.8 six months after. The control group had a MHQ score of 54.2 ± 7.1 before treatment and 57.8 ± 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.59-63
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• 2022

Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.

• Journal of Veterinary Clinics
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• v.24 no.4
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• pp.514-521
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• 2007

The sympathetic nerve block improves the blood flow in the innervated regions. For this region, the sympathetic nerve block has been performed in the neural and cerebral disorders. However, the cerebral blood flow regulation of the cranial cervical ganglion block in dogs have not been well defined and the correlation to the changes in the cerebral circulation and the changes in the electroencephalogram is not well defined in dogs yet. Therefore, we investigated the hypothesis that changes in the EEG could be affected by the changes in cerebral blood flow following the cranial cervical ganglion block in dogs. Twenty five beagle dogs were divided into 3 groups; group I(LCCGB, n=10) underwent left sided cranial cervical ganglion block using the 1% lidocaine, group II(L, n=10) injected the 1% lidocaine into the right or left sided digastricus muscle, group III(N/SCCGB, n=5, served as control) underwent the left sided cranial cervical ganglion block using saline. A statistical difference was not found between the control group and the LCCGB group in the 95% spectral edge frequency(SEF) and the median frequency(MF). In the relative band power, the $\delta$ frequency was decreased during 5-25 min, while the $\alpha$ frequency was increased during the same time(p<0.05). But the $\theta$ frequency and the $\beta$ frequency were not shown the significant changes compared with the control group during the same time(p<0.05). These results suggest that the left cranial cervical ganglion block does not induce the change of the cerebral blood flow and its effect is insignificant.