• Archives of Plastic Surgery
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• 제43권5호
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• pp.395-401
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• 2016

Background Some of the relatively newer, more efficacious, and potent topical wound dressing solutions include tetrachlorodecaoxide and super-oxidised solution. This study compares the efficacy and safety of these two drugs. Methods This is a block-randomised, double blind, parallel-arm, post-marketing study. One hundred fifty patients with ulcers (75 blocks uniform for sex, ulcer aetiology, diabetes mellitus, and wound area score) were randomised into the two treatment arms. Patients were observed for eight weeks with weekly assessments. One hundred and twenty patients completed the study. Wound healing was objectively assessed by measurement of wound area, scoring of wound exudation and tissue type, and using the pressure ulcer scale of healing Tool (validated for multiple wound aetiologies). Subjective improvement in pain was noted using a visual analogue scale. Both groups were compared using Mann-Whitney U test on all indicators. Results Difference in change in wound tissue type in the two groups was significant (${\alpha}$=0.05) by intention-to-treat (ITT) and per-protocol (PP) analysis at the end of week two (ITT and PP, P<0.001) and week four (ITT, P=0.010; PP, P=0.009). P-values for other comparisons were not significant (P>0.05). No study-related adverse events were observed. Conclusions Both drugs are efficacious. Tetrachlorodecaoxide yields healthy granulation tissue earlier. Both drugs appear to be safe for application.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5753-5759
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• 2013

Curcumin and curcumin containing polyherbal preparations have demonstrated anti-microbial and antiviral properties in pre-clinical studies. Till date no therapeutic intervention has been proved to be effective and safe in clearing established cervical human papillomavirus (HPV) infection. The present study evaluated the efficacy of Basant polyherbal vaginal cream (containing extracts of curcumin, reetha, amla and aloe vera) and of curcumin vaginal capsules to eliminate HPV infection from cervix. Women were screened by Pap smear and HPV DNA test by PCR. HPV positive women without high grade cervical neoplasias (N=287) were randomized to four intervention arms to be treated with vaginal Basant cream, vaginal placebo cream, curcumin vaginal capsules and placebo vaginal capsules respectively. All subjects were instructed to use one application of the assigned formulation daily for 30 consecutive days except during menstruation and recalled within seven days of the last application for repeat HPV test, cytology and colposcopy. HPV clearance rate in Basant arm (87.7%) was significantly higher than the combined placebo arms (73.3%). Curcumin caused higher rate of clearance (81.3%) than placebo though the difference was not statistically significant. Vaginal irritation and itching, mostly mild to moderate, was significantly higher after Basant application. No serious adverse events were noted.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.767-776
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• 2020

Objective : The aim of this study is to evaluate the feasibility of posterior cervical foraminotomy (PCF) for adjacent segmental disease (ASD) after anterior cervical fusion (ACF). As ACF is accepted as the standard treatment for cervical spondylosis, many studies have been conducted to evaluate the efficacy of various surgical techniques to overcome symptomatic ASD after the previous surgery. Herein, PCF was performed for the treatment of symptomatic ASD and the feasibility of the surgery was evaluated. Methods : Forty nine patients who underwent PCF due to symptomatic ASD from August 2008 to November 2017 were identified. For demographic and perioperative data, the sex, age, types of previous surgery, ASD levels, operation times, and bleeding amount were recorded. The clinical outcome was assessed using the visual analogue scale for the neck and arm, the modified Odom's criteria as well as neck disability index. Radiologic evaluations were performed by measuring disc softness, disc height, the cervical 2-7 sagittal vertical axis, cervical cobb angle, and facet violation. Results : Thirty-seven patients were enrolled in this study. The patients were divided into two groups based on the location of the pathology; paracentral (group P) or foramina (group F). Both groups showed significant clinical improvement (p<0.05). The proportion of calcified disc and facet violations was significantly larger in group F (p<0.05). The minimal disc height decrease with mild improvement on sagittal alignment and cervical lordosis was radiologically measured without statistical significance in both groups (p>0.05). Conclusion : PCF showed satisfactory clinical and radiologic outcomes for both paracentral and foraminal pathologies of ASD after ACF. Complications related to anterior revision were also avoided. PCF can be considered a feasible and safe surgical option for ASD after ACF.

• 패션비즈니스
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• 제24권2호
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• pp.60-67
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• 2020

This study evaluated the Skin Whitening effects of 'fermented-C.' for Atrium cosmetics using a single-arm clinical trial. Twenty female adults (mean age 42.1 ± 6.6 year) were enrolled, all participants used this cosmetic product on their face for 4 weeks. The change of brightness (L-value) was measured by spectrophotometer while subjective assessments were also obtained to find the participants opinions on whitening and their general satisfaction measured by a 5-point scale (5 for very satisfactory, 5 for satisfactory, 3 for moderate, 2 for unsatisfactory, 1 for very unsatisfactory). The participants were also questioned about any adverse effects by filling out a self-monitoring report. The average L-value increased from 62.55 ± 2.14 on day 0 to 63.22 ± 1.96 after 4 weeks corresponding to a 1.1% brightness improvement (p < 0.01). The average scores for subjective whitening and general satisfaction were better than moderate with scores of 3.6 ± 0.5 and 3.7 ± 0.7, respectively. No notable complaints were reported regarding any kind of adverse effects such as erythema, itching or burning. The clinical data collected in this study supports that fermented-C. from Atrium cosmetics has whitening potential in a safe Functional Cosmetics package.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.562-570
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• 2014

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.

• The Korean Journal of Pain
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• 제10권2호
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• pp.225-230
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• 1997

Background: Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. Method: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23~25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The "pop" was well noted well. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. Result: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13($10.0{\pm}1.7$) cm. Tip of catheter was placed in infraclavicular space(66.7%), about the humeral head(17.9%) and in upper arm in 3 cases as U-shape(7.9%). Catheters were maintained for $6.7{\pm}2.6$(3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma. Conclusion: This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

• The Korean Journal of Pain
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• 제12권1호
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• pp.81-86
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• 1999

Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.

• 대한약침학회지
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• 제20권3호
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• pp.227-229
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• 2017

Fibrosis of skeletal muscle following acupuncture is an iatrogenic disorder. The present case illustrates a patient with a unilateral fibrotic formation on a thumb muscle after acupuncture injection therapy with red sage. The patient in the present case was a counter-terrorism police officer with right-handedness; he noted a palpable nodule three months after injection therapy at his left first dorsal interosseous in which the acupuncture point LI4 (He Gu) is located. He also found a reduction in the strength of his left pinch grip that noticeably affected his left handgun marksmanship. However, being ambidextrous in single-hand pistol shooting is an essential requirement for counter-terrorism police officers. Based on the patient's medical history and claims, no underlying disease or trauma was found to be associated with his current complaint. During physical examination, a fibrotic formation in his left first dorsal interosseous muscle was visualized by using diagnostic ultrasound; also, as confirmed with dynamometry, the strength of his left pinch grip was significantly lower than that of the right counterpart. Because acupuncture injection therapy has three components, antiseptic practices, the mechanical action of syringe insertion, and the pharmacological effect of the sterile herb extract, any one of the components may have contributed to the present adverse event. The first dorsal interosseous muscle is small in dimension and rather vascular; thus, it is not an ideal site for intramuscular injection. When a clinician needs to treat a patient by performing acupuncture at the LI4 acupoint and injecting a herbal extract simultaneously, the clinician should only mechanically stimulate the LI4 acupoint while injecting the herbal medicine into the LI14 (Bi Noe) acupoint on the same meridian, the LI14 acupoint being located in the distal portion of the deltoid muscle and being fairly close to the universally agreed upon site on the upper arm for safe administration of an injection.

• The Korean Journal of Pain
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• 제24권4호
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• pp.205-215
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• 2011

Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

• Advances in Traditional Medicine
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• 제9권2호
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• pp.142-148
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• 2009

Anxiety disorders are one of the serious problems which need proper therapy devoid of side effects of presently available medicines. The present study evaluates the anxiolytic and sedative activity of leaf galls of Piper nigrum Linn. in Swiss Albino mice. The pet. ether, chloroform, ethyl acetate and ethanol extracts of leaf galls of Piper nigrum Linn were obtained by continuous soxhlet extraction. The prepared extracts were found to be safe up to 2000 mg/kg body weight of mice in the acute toxicity study. Each extract was assessed for anxiolytic activity in Swiss Albino mice by elevated plus Maze, open field test, rota rod test and phenobarbitone induced sleeping time test. In the Elevated Plus Maze test, the pet.ether extract and chloroform extract at a dose of 50 mg/kg b.w. orally, significantly (P < 0.01) increased the number of entries and time spent in open arm comparable with standard diazepam at the dose of 10 mg/kg. b.w. p.o. In the open field test, pet. ether extract (50 mg/kg b.w. p.o.) showed significant increase (P < 0.01) in ambulation and activity in the center. Chloroform extract (50 mg/kg b.w p.o.) was significant (P < 0.05) for both ambulation and center activity. Pet. ether extract (50 mg/kg b.w. p.o) also showed significant activity (P < 0.01) in rota rod test. All the results are comparable with standard diazepam at the dose of 1 mg /kg b.w, p.o. Moreover all the extracts showed significant (P < 0.01) increase in the phenobarbitone induced sleeping time among which pet.ether showed more prominent activity (36%) comparable with control. The results revealed that, the active pet.ether extract and chloroform extract of leaf galls of Piper nigrum Linn is worthwhile to develop the bioactive principle for anxiolytic activity.