• Archives of Plastic Surgery
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• v.50 no.3
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• pp.264-273
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• 2023

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.757-765
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• 2000

Background : Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count as a measure of tumor angiogenesis, has been significantly correlated with invasive and metastatic patterns in breast. prostate and cutaneous carcinomas. Materials and Methods : Fifty patients with curatively resected non-small cell lung cancer were evaluated. Tumor tissues embedded in paraffin block were stained by anti CD 31 (PECAM, platelet endothelial cellular adhesion molecule) using immunohistochemical method to assess microvessel count. Microvessels were counted in the most active areas of neovascularization(microscopy, 200$\times$). Results: 1) Mean microvessel count was 47.1$\pm$17.7(per 200$\times$field) in total 50 cases. 2) Mean microvessel count of adenocarcinoma (54.4$\pm$19.9) was significantly higher than that of squamous cancer (43.9$\pm$16.2) (p<0.05), but there were no relationship between microvessel count and TNM stages. 3) Median survival time, 2-year and 5-year survival rates of the low microvascular group (microvessel count<45, 22 cases) were 61 months, 80% and 40%, respectively, and those of the high microvascular group(microvessel count$\geq$45, 28 cases) were 46 months, 75% and 12%, respectively. As results, prognosis of low microvascular group is statistically significantly superior to that of the high microvascular group (p=0.0162, Kaplan-Meier, log-rank). Conclusion : Angiogenesis assessed by microvessel count can be used as one of the significant prognostic factors in non-small cell lung cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.2
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• pp.67-76
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• 2016

Dracunculiasis, otherwise known as guinea worm disease (GWD), is caused by infection with the nematode Dracunculus medinensis. This nematode is transmitted to humans exclusively via contaminated drinking water. The transmitting vectors are Cyclops copepods (water fleas), which are tiny free-swimming crustaceans usually found abundantly in freshwater ponds. Humans can acquire GWD by drinking water that contains vectors infected with guinea worm larvae. This disease is prevalent in some of the most deprived areas of the world, and no vaccine or medicine is currently available. International efforts to eradicate dracunculiasis began in the early 1980s. Most dentists and maxillofacial surgeons have neglected this kind of parasite infection. However, when performing charitable work in developing countries near the tropic lines or other regions where GWD is endemic, it is important to consider GWD in cases of swelling or tumors of unknown origin. This paper reviews the pathogenesis, epidemiology, clinical criteria, diagnostic criteria, treatment, and prevention of dracunculiasis. It also summarizes important factors for maxillofacial surgeons to consider.

• Proceedings of the Korean Institute of Intelligent Systems Conference
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• 2003.09a
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• pp.372-375
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• 2003

The incidence of blindness resulting from diabetic retinopathy has significantly increased despite the intervention of insulin to control diabetes mellitus. Early signs are microaneurysms, exudates, intraretinal hemorrhages, cotton wool patches, microvascular abnormalities, and venous beading. Advanced stages include neovascularization, fibrous formations, preretinal and vitreous microhemorrhages, and retinal detachment. Microaneurysm count is important because it is an indicator of retinopathy progression. The purpose of this paper is to apply data mining to detect diabetic retinopathy patterns in routine fundus fluorescein angiography. Early symptoms are of principal interest and therefore the emphasis is on detecting microaneurysms rather than vessel tortuosity. The analysis does not involve image-recognition algorithms. Instead, mathematical filtering isolates microaneurysms, microhemorrhages, and exudates as objects of disconnected sets. A neural network is trained on their distribution to return fractal dimension. Hausdorff and box counting dimensions grade progression of the disease. The field is acquired on fluorescein angiography with resolution superior to color ophthalmoscopy, or on patterns produced by physical or mathematical simulations that model viscous fingering of water with additives percolated through porous media. A mathematical filter and neural network perform the screening process thereby eliminating the time consuming operation of determining fractal set dimension in every case.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.288-297
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• 2005

Rehabilitation of the paralyzed face as a result of trauma or surgery remains a daunting task. Complete restoration of emotionally driven symmetric facial motion is still unobtainable, but current techniques have enhanced our ability to improve this emotionally traumatic deficit. Problems of mass movement and synkinesis still plague even the best reconstructions. The reconstructive techniques used still represent a compromise between obtainable symmetry and motion at the expense of donor site deficits, but current techniques continue to refine and limit this morbidity. In chronically paralyzed face, direct nerve anastomosis, nerve graft, or microvascular-muscle graft is not always possible. In this case, regional muscle transposition is tried to reanimate the eyelid and lower face. Regional muscle includes maseeter muscle, temporalis muscle and anterior belly of the digastric muscle. Temporalis muscle is preferred because it is long, flat, pliable and wide-motion of excursion. In order to reanimate the upper and lower eyelid, Upper eyelid Gold weight implantion and lower eyelid shortening and tightening is mainly used recently, because this method is very simple, easy and reliable.

• Imaging Science in Dentistry
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• v.32 no.1
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• pp.49-53
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• 2002

Orofacial pain can be caused by intracranial disorders or can be musculoskeletal, vascular, internal derangemental, and neurologic in origin. The neurologic pain is derived from structural and functional disorders of nerve, and the trigeminal neuralgia is the typical manifestation. Trigeminal neuralgia is known from centuries ago, and is one of the most common pains in human. We present our experience with three patients who have trigeminal neuralgia. The first case is a 50-year-old female who had no specific evidence radiographically. Second is a 50-year-old male with microvascular compression on right trigeminal nerve. The third case is a 60-year-old female who had a neoplasm in cerebellopontine angle with associated mass effect.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.245-252
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• 2016

Regional anesthesia in the maxillofacial region is safer and more efficient than general anesthesia when its indications are carefully considered. In addition, the majority of medical institutions in developing countries are not well equipped for proper anesthesia and elective surgery. In this review, we describe regional anesthesia and cutaneous nerve divisions in the maxillofacial region. In addition, we summarize detailed regional anesthetic techniques adapted for representative cleft lip cases in developing countries.

• Biomolecules & Therapeutics
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• v.12 no.2
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• pp.62-67
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• 2004

Trauma remains one of the important sources leading to systemic inflammatory response anti sub-sequent multiple organ failure. Although hepatic microvascular dysfunction occurs during trauma, the mechanism responsible remains unclear. The aim of this study was to investigate the effect of trauma on hepatic vascular stress gene expression. Femur fracture (EFx) was induced by torsion to the femur at midshaft. Liver samples were taken for RT-PCR analysis of mRNA for gtenes of interest: endothelin-1 (ET-1), its receptors $ET_A$ and $ET_B$, nitric oxide synthases (iNOS and eNOS), cyclooxygenase-2 (COX-2), heme oxygenase-1 (HO-1), and tumor necrosis tactor-${\alpha}$ (TNF-${\alpha}$). The expression of ET-1 mRNA was significantly increased by FFx. Expression of mRNA in FFx group showed no change in $ET_A$, $ET_B$, iNOS and HO-1 and showed a slight increase of 2.2-fold and 2.7-fold for eNOS tll1d COX-2, respectively. The level of TNF-${\alpha}$ mRNA significantly increased in FFx group. In conclusion, mild trauma alone causes little change in expression of vasoactive mediators.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.116-123
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• 2011

The incidence of breast cancer, the second most prevalent cancer type in South Korea, has increased by 6.8% annually in the last six years. The higher number of breast cancer patients has led to an increase in the cases of skin-sparing mastectomies, thereby increasing the need for reconstructive procedures. The reconstruction options include alloplastic techniques such as implant or autologous reconstruction with numerous flaps. The abdominal area is the preferred donor site for the harvest of autologous tissue for breast reconstruction. Breast reconstruction using abdonimal tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing TRAM, DIEP, and SIEA flap techniques were later developed in an effort to decrease the abdominal-donar-site morbidity by decreasing the injury to the rectus abdominis muscle and fascia. This article summarizes the various abdominal flaps for breast reconstruction.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.261-265
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• 2001

Radiofrequency thermocoagulation of the gasserian ganglion is a safe procedure that can be controlled well and provides satisfactory pain relief from trigeminal neuralgia with low risk. Here the authors report a case of radiofrequency thermocoagulation performed on a recurred trigeminal neuralgia patient, with particular attention to the V3 area. The patient was treated with microvascular decompression 7 years previous, which lead to untolerable side effects from carbamazepine medication. Following the paresthesia and masseter muscle contracture test at 50 Hz-0.06 volt and 2 Hz-0.5 volt respectively, RF lesionings were performed for 60 sec at $60^{\circ}C$ and 70 sec at $70^{\circ}C$. One week after the procedure, the pain was reduced with a mild hypoesthesia in the V2 area. After 6 months, the pain recurred. Therefore, we performed the same procedure again. After 8-months of follow-up, there has been no pain or complications.