• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.595-599
• /
• 2010

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.

• Journal of Pharmaceutical Investigation
• /
• v.8 no.1
• /
• pp.17-26
• /
• 1978

Effects of Acanthopanax EtOH Extract (AEE) on the serum total cholesterol content of normal and cholesterol administered rabbits were investigated as a series of studies on pharmacological action, especially blood pressure to Korean Acanthopanax. AEE was administered orally(100mg/kg/day) and subcutaneously (30mg/kg/day) in both normal and cholesterol administered rabbits for 36 days. In this experiment the results obtained by comparing with values of the corresponding control group were as follows; 1) In the normal rabbits, long-term administration of AEE for 36 days did not entirely influence the serum total cholesterol content measured at 12th, 24th and 36th day and also not affect the original blood pressure and changes of blood pressure to norepinephrine, angiotensin and acetylcholine recorded at 36th day. 2) In the cholesterol administered rabbits, hypercholesteremia was induced by oral administration of cholesterol(300mg/kg/day) with feed. The rise rate of serum total cholesterol content was not modified at 12th day, whereas significantly inhibited at 24th and 36th days after begining this examination in both groups orally and subcutaneously administered AEE. Original blood pressure was declined and depressor action of acetylcholine was weakened in only group admininstered orally AEE of cholesterol-fed groups. Changes of blood pressure to norepinephrine and angiotensin in these all cholesterol-fed groups, and to acetylcholine in subcutaneous group of these cholesterol-fed groups were not affected significantly by AEE.

• Journal of Digital Convergence
• /
• v.14 no.11
• /
• pp.589-596
• /
• 2016

The purpose of current study was to investigate the correlations of walking exercise program-induced abdominal visceral fat loss with metabolic syndrome risk factors in middle-aged women. The walking exercise program was provided at a frequency of 3 sessions, respectively, per week for a duration of 12 weeks. Then, the subjects were classified into either those whose abdominal visceral fat loss belonged to low 25 percentile (low 25% group, n=8) or those whose abdominal visceral fat loss belonged to high 25 percentile(high 25% group, n=8) based on the amount of abdominal visceral fat loss induced by the walking exercise. Metabolic syndrome risk factors(waist circumference, triglycerides, HDL-cholesterol, fasting blood glucose, blood pressure) between groups according to the 12 weekly walking exercise program had no difference. In conclusion, the findings of the present study show that the walking exercise-induced total abdominal fat and visceral fat loss were positively relate to waist and blood pressure(SBP, DBP) and that the walking exercise-induced subcutaneous fat loss were positively relate to waist and blood pressure(SBP).

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.20 no.1
• /
• pp.65-74
• /
• 2019

■ Objectives The purpose of this case study is to report the effectiveness of Korean medicine and pharmacopuncture in the treatment of pressure ulcer. ■ Methods The patient with pressure ulcer was treated with herbal medicine, Hwangryunhaedoktang pharmacopuncture, acu-moxi treatment. We started herbal medicine mainly Taklisodok-um for pressure ulcer, but changed to Paljung-san due to urinary tract infection on Day 67. During the daily dressing, we inject pharmacopuncture solution subcutaneous ulcer area and spray solution on the cavity of right pressure ulcer. The severity of pressure ulcer was assessed using[NPUAP] pressure ulcer stage, healing rate of pressure ulcer and depth of right side ulcer cavity on Day1, Day15, Day40, Day73, Day95. ■ Results After treatment, the total size of the pressure ulcer was reduced from 90(10*9) to 56(8*7)cm², healing rate of pressure ulcer increased to 37.8%, depth of pressure ulcer was reduced from 3.5 to 2cm. Though NPUAP stage(Gr 4) was not changed, size and color of pressure ulcer definitely improved compared to Day1. ■ Conclusion This study suggested taht Korean medical treatment could be effective option for treating grade 4 pressure ulcer.

• The Korean Journal of Pain
• /
• v.28 no.4
• /
• pp.280-283
• /
• 2015

Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

• Korean Journal of Applied Biomechanics
• /
• v.19 no.2
• /
• pp.197-204
• /
• 2009

It bas been hypothesized that foot ulceration might be internally initiated. Current instruments which merely allow superficial estimate of plantar loading acting on the foot, severely limit the scope of many biomechanical/clinical studies on this issue. Recent studies have suggested that peak plantar pressure may be only 65% specific for the development of ulceration. These limitations are at least partially due to surface pressures not being representative of the complex mechanical stress developed inside the subcutaneous plantar soft-tissue, which are potentially more relevant for tissue breakdown. This study established a three-dimensional and nonlinear finite element model of a human foot complex with comprehensive skeletal and soft-tissue components capable of predicting both the external and internal stresses and deformations of the foot. The model was validated by experimental data of subject-specific plantar foot pressure measures. The stress analysis indicated the internal stresses doses were site-dependent and the observation found a change between 1.5 to 4.5 times the external stresses on the foot plantar surface. The results yielded insights into the internal loading conditions of the plantar soft-tissue, which is important in enhancing our knowledge on the causes of foot ulceration and related stress-induced tissue breakdown in diabetic foot.

• Journal of Trauma and Injury
• /
• v.33 no.4
• /
• pp.260-263
• /
• 2020

Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

• Journal of radiological science and technology
• /
• v.31 no.1
• /
• pp.33-39
• /
• 2008

Abdominal obesity, especially, visceral obesity is thought to be a risk factor of type 2 diabetes and cardiovascular disease such as hypertension, hyperlipidemia, coronary artery disease. Based on previous studies visceral fat accumulation is highly related to these diseases compared to subcutaneous fat accumulation. The purpose of this study was to see the relation between abdominal obesity and lipid profiles in adult women. The included subjects were 25 adult women(BMI > $23\;kg/m^2$), who visited the obesity clinic in a general hospital from April 2006 to September 2007. Blood pressure, fasting glucose and lipid profiles were measured. The abdominal fat distribution had been assessed by CT scan at the level of L4-L5. From bivariate analyses, the visceral fat accumulation showed negative correlations with TC and TC/HDL. The BMI, total abdominal fat and Visceral fat/Subcutaneous fat ratio showed significant correlations with visceral fat accumulation. From linear regression analyses of all the study subjects, TC, TG and HDL were found to be determinants of the visceral fat accumulation($R^2\;=\;0.474$).

• Journal of Nutrition and Health
• /
• v.26 no.3
• /
• pp.299-312
• /
• 1993

Anthropometry, computed tomography(CT) at the umbilical level, nutrient intake, blood pressure, serum levels of lipids and lipoproteins and response of glucose, c-peptide, insulin, and free fatty acid(FFA) during oral glucose tolerance test(OGTT) were estimated on 11 normal-weight controls and 35 overweight and obese middle-agd men. The areas of total abdominal, subcutaneous and visceral were determined by CT scanning technique. Total abdominal fat area correlated the most significantly with the levels of serum lipids, lipoproteins and insulin among several obese indices. Compared with normal-weight controls, overweight and obese men with abdominal fat lower than 29000$\textrm{mm}^2$ showed an increase in waist-hip ratio, areas of total abdominal(35%), visceral and subcutaneous fat and C-peptide response area during OGTT, though age, percent ideal body weight, body mass index, % body fat, and all biochemical indices except C-peptide response area were not different between two groups. Overweight and obese men with abdominal fat greater than 29000$\textrm{mm}^2$ showed a higher values in total abdominal fat(85%), serum levels of triglyceride, total-and LDL-cholesterol, the ratio of LDL-to HDL-cholesterol, and response areas of FFA, insulin and C-peptide during OGTT than normal-weight controls. Overweight and obese men with great abdominal fat showed an increase in alcohol ingestion and percent calorie intake per total energy expenditure, compared with normal-weight controls. Our results indicate that obesity and a certain level of total abdominal fat accumulation is required to observe abnormal levels of serum lipids, lipoproteins and insulin in Korean middle-aged men. In addition, increased alcohol and calorie intake and decreased physical activity could partly explain total abdominal fat accumulation in men.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.6
• /
• pp.585-589
• /
• 2001

Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperitonewn, pnewnomediastinwn, and subcutaneous emphysema developed. She was treated with mechanical ventilation and medical therapy. The pneumoperitonewn was resolved after 27days. Here, we report this case with the review of the relevant literature.