• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.1-15
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• 1996

From Fabuary 1982 to May 1995, 396 patients had undergone reconstructive surgery of the upper and lower limb with microsurgical technique at department of orthopaedic surgery, Yonsei University of Medicine. The results were as follows; 1. Average age at the time of operation was 23.4years(2-64 years), and there were 277 male and 119 female patients. 2. Among 324 patients of soft tissue flap(87 inguinal flap, 132 scapular flap, 38 latissimus dorsi flap, 11 latissimus dorsi and scapular combind flap, 6 gracilis flap, 12 deltoid flap, 3 tensor facia lata flap, 11 dorsalis pedis flap, 6 lateral thigh flap, 12 wrap around flap, 1 lateral arm flap, 5 musculocutaneous flap), 274 cases(85.5%) were succeed. 3. Among 37 patients of vascularized bone graft(18 fibular bone graft, 11 iliac bone graft, 7 toe to finger transplantation,1 vascular pedicle rib graft), 30 cases(80.1%) were succeed. 4. In 26 cases of segmental resection and rotationplasty at lower extremity, 23 cases were succeed. 5. In 7 cases of Tikhoff-Linberg procedure and in 2 case of segmental resection and replantation, all case was succeed. Overall success rate of microscopic reconstructive surgery was 85.6%. In conclusion, microsurgical technigue is valuable for reconstruction of tissue defect or function loss of the limb.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.377-382
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• 2007

Purpose: Hook nail deformity is caused by inadequately supported nail bed due to loss of distal phalanx or lack of soft tissue, resulting in a claw-like nail form. A composite graft from the foot bencath the nail bed gives adequate restoration of tip pulp. Methods: From September of 1999 to March of 2004, six patients were treated for hook nail deformity and monitored for long term follow up. Donor sites were the lateral side of the big toe or instep area of the foot. We examined cosmetic appearance and nail hooking and sensory test. The curved nail was measured by the picture of before and after surgery. Results: In all cases, composite grafts were well taken, and hook nail deformities were corrected. The curved nail of the 4 patients after surgery were improved to average $28.7^{\circ}$ from average $55.2^{\circ}$ before surgery. The static two point discrimination average was 6.5mm and the moving two point discrimination average was 5.8mm in the sensory test. Conclusion: Composite graft taken from foot supports the nail bed with the tissue closely resembling the fingertip tissue, making it possible for anatomical and histological rebuilding of fingertip.

• Geomechanics and Engineering
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• v.17 no.1
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• pp.109-118
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• 2019

The movement of soil along a slope during rainfall can cause serious economic damage and can jeopardize human life. Accordingly, predicting slope stability during rainfall is a major issue in geotechnical engineering. Due to rainwater penetrating the soil, the negative pore water pressure will decrease, in turn causing a loss of shear strength in the soil and ultimately slope failure. More seriously, many constructions such as houses and transmission towers built in/on slopes are at risk when the slopes fail. In this study, the numerical simulation using 2D finite difference program, which can solve a fully coupled hydromechanical problems, was used to evaluate the effects of soil properties, rainfall conditions, and the location of a foundation on the slope instability and slope failure mechanisms during rainfall. A slope with a transmission tower located in Namyangju, South Korea was analyzed in this study. The results showed that the correlation between permeability and rainfall intensity had an important role in changing the pore water pressure via controlling the infiltrated rainwater. The foundation of the transmission tower was stable during rainfall because the slope failure was estimated to occur at the toe of the slope, and did not go through the foundation.

• Archives of Reconstructive Microsurgery
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• v.2 no.1
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• pp.46-52
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• 1993

Soft-tissue deficits over the plantar forefoot, plantar heel, Achilles tendon, and distal parts of lower leg are often troublesome to cover with a simple graft or local flap due to limited mobility of surrounding skin and poor circulation in these area. Soft-tissue reconstruction in these regions should provide tissue components similar to the original lost tissue, supply durability and minimal protective pressure sensation and result in a donor site that is well tolerated and treated. We analysed 7 cases that were treated with the Instep flap due to soft-tissue defects over these regions from July of 1990 to July of 1993. All flaps were viable and successful at follow-up. 1. The age ranged from 9 years to 60 years, and 6 cases were male and 1 case female. 2. The sites of soft-tissue loss were the plantar forefoot(1 case), plantar heel(3 cases), Achilles tendon(2 cases), and distal parts of lower leg(1 case). 3. The causes of soft-tissue loss were simple soft-tissue crushing injury(1 case), crushing injury of the 1st toe(1 case) and posttraumatic infection and necrosis(5 cases). 4. The associated injury were open distal tibio-fibula, fracture(2 cases), medial malleolar fracture of the ankle(1 case), Achilles tendon rupture(2 case) and 1st metatarso-phalangeal disarticulation(1 case). 5. The size of flap was from $3{\times}4cm$ to $5{\times}10cm$(average $4{\times}5.6cm)$. 6. In 7 cases, we were not to find post-operative necrosis and infection, non-viability, limitation of ankle joint, and gait disturbance caused by the Instep flap surgery. 7. This study demonstrates that the Instep flap should be considered as another valuable technique in reconstruction of these regions.

• Geomechanics and Engineering
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• v.30 no.2
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• pp.169-185
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• 2022

The urbanization and increasing rate of population demands effective means of transportation system (basement and tunnels) as well as high-rise building (resting on piled foundation) for accommodation. Therefore, it unavoidable to construct basements (i.e., excavation) nearby piled foundation. Since the basement excavation inevitably induces soil movement and stress changes in the ground, it may cause differential settlements to nearby piled raft foundation. To understand settlement and load transfer mechanism in the piled raft due to excavation-induced stress release, numerical parametric studies are carried out in this study. The effects of excavation depths (i.e., formation level) relative to piled raft were investigated by simulating the excavation near the pile shaft (i.e., H_e/L_p=0.67), next to (H_e/L_p=1.00) and below the pile toe (H_e/L_p=1.33). In addition, effects of sand density and raft fixity condition were investigated. The computed results have revealed that the induced settlement, tilting, pile lateral movement and load transfer mechanism in the piled raft depends upon the embedded depth of the diaphragm wall. Additional settlement of the piled raft due to excavation can be account for apparent loss of load carrying capacity of the piled raft (ALPC). The highest apparent loss of piled raft capacity ALPC (on the account of induced piled raft settlement) of 50% was calculated in in case of H_e/L_p = 1.33. Furthermore, the induced settlement decreased with increasing the relative density from 30% to 90%. On the contrary, the tilting of the raft increases in denser ground. The larger bending moment and lateral force was induced at the piled heads in fixed and pinned raft condition.

• Archives of Reconstructive Microsurgery
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• v.21 no.1
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• pp.56-60
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• 2012

Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

• Journal of Veterinary Clinics
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• v.16 no.1
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• pp.86-94
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• 1999

To invstigate the available dosage and effects of xylazine as preanesthetics on the propofol anesthesia in the dog, the experimental animals were randomly divided into 3 groups (xylazine 0.55 mg/kg (group 1), 1 mg/kg (group 2) and 2 mg/kg (group 3) were premedicated) and, monitored analgesic and anesthetic effect, body temperature, respiratory rate (breaths/minute), heart rate (beats/minutes). Also, hematological and serum chemical changes were monitored. In all experimental groups, the animals were recumbent just after propofol injection and time difference was not detected. Except vomitting after xylazine injection and insignificant ataxia during recovery, no significant side effects were observed. In group 2, loss of toe-web needle prick response time was slightly longer than group 1 but the response in group 2 and group 3 were similar, In group 2 and 3, the duration of anesthesia was longer than group 1 (2 folds) but there was no difference between group 2 and 3. Recovery time was prolonged in proportion to administration dosage of xylazine. In all experimental groups, the body temperature of animals was decresed gradually according to experimental time but no significant changes were monitored. The heart rate and respiratory rate were significantly (p<0.01, p<0.05) decreased after propofol injection Hematologically, no significant changes were monitored in total leukocye numbers, total erythrocye numbers, MCV, MCH, MCHC, serum GOT and GPT values Significant changes in all groups were not observed except significant increase in BUN, total-protein and abumin values of group 3. On the basis of these result, premedication of xylazine can be helpful in decresing some side effects and the dosage of propofol. 1 mg/kg of xylazine as preanesthetics on the propofol anesthesia in the dog is considered to be available.

• Korean Journal of Veterinary Research
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• v.38 no.2
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• pp.401-412
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• 1998

This study was conducted to compare the anesthetic effects of intravenous tiletamine-zolazepam(TZ, 7mg/kg TZ), tiletamine-zolazepam-xylazine(TZX, 7mg/kg TZ and 1.1mg/kg X) and ketamine-xylazine(KX, 10mg/kg K and 1.1mg/kg X). Fifteen mixed-breed healthy dogs($3.5{\pm}1.0kg$) were randomly assigned to the three treatment groups(TZ, TZX, KX) with 5 dogs in each group. The mean surgical anesthesia time was $25.6{\pm}4.2$, $62.6{\pm}6.2$ and $21.0{\pm}3.7$ min in TZ-, TZX- and KX-anesthetized dogs, respectively. The duration of the loss of response to toe-web needle prick and to visceral pain was significantly increased in the TZX group with $40.0{\pm}15.8$ min and $44.0{\pm}5.5$ min, respectively(p<0.01). Heart rate decreased significantly below baseline in TZX and KX groups(p<0.05, p<0.01) whereas it increased above baseline in TZ group. Respiratory rate remained unchanged or increased above baseline in TZ group, but decreased significantly from 10 to 30 min in TZX(p<0.01, p<0.05) and at 10 min in KX group(p<0.05). Body temperature decreased significantly below baseline in all three groups(p<0.01, p<0.05). Hematologic(PCV, RBC, WBC) and serum chemistry values(GOT, GPT, BUN, creatinine, total protein, glucose) were monitored before anesthesia, after recovery from anesthesia and 1, 3 and 7 days postanesthesia. All hematologic values remained generally within normal ranges, and GOT, GPT, BUN, creatinine and total protein values were within normal ranges during the period. Glucose values for TZX and KX groups increased greatly after recovery from anesthesia. We conclude that tiletamine-zolazepam-xylazine provides effective surgical anesthesia in dogs and in many cases may be preferable to conventional ketamine-xylazine regimen.

• Journal of Ginseng Research
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• v.44 no.6
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• pp.833-842
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• 2020

Background: Ulcerative colitis (UC) is a commonly encountered large intestine disease in the contemporary world that terminates into colorectal cancer; therefore, the timely treatment of UC is of major concern. Panax ginseng Meyer is an extensively consumed herbal commodity in South East Asian countries, especially Korea. It exhibits a wide range of biologically beneficial qualities for almost head-to-toe ailments in the body. Epimedium koreanum Nakai (EKN) is also a widely used traditional Korean herbal medicine used for treating infertility, rheumatism, and cardiovascular diseases. Materials and methods: Separately the anti-inflammatory activities of both red ginseng extracts (RGEs) and EKNs had been demonstrated in the past in various inflammatory models; however, we sought to unravel the anti-inflammatory activities of the combination of these two extracts in dextran sulfate sodium (DSS)-induced ulcerative colitis in mice model because the allopathic remedies for UC involve more side effects than benefits. Results: Our results have shown that the combination of RGE + EKN synergistically alleviated the macroscopic lesions in DSS-induced colitic mice such as colon shortening, hematochezia, and weight loss. Moreover, it restored the histopathological lesions in mice and decreased the levels of proinflammatory mediators and cytokines through the repression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP-3) expression. In vitro, this combination also reduced the magnitude of nitric acid (NO), proinflammatory mediators and cytokine through NF-κB and mitogen-activated protein kinase (MAPK) pathways in RAW 264.7 mouse macrophage cells. Conclusion: In the light of these findings, we can endorse this combination extract as a functional food for the prophylactic as well as therapeutic treatment of UC in humans together with allopathic remedies.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.