• Archives of Plastic Surgery
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• 제41권3호
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• pp.271-276
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• 2014

Background As the obese population increases in Korea, the number of patients who are trying to lose weight has been increasing steadily. In these patients, skin laxity and deformation of the body contour occurs, which could possibly be corrected by various body contouring surgeries. Here, we introduce the brachioplasty method and our experience of various body contouring surgeries performed in our center. Methods From November 2009 to August 2011, five cases of brachioplasty were performed. When the patient presented with sagging of the lateral inframammary crease and bat wing deformity in the axilla, extended brachioplasty was performed; in this case, the deformation of the axilla and lateral chest was corrected at the same time. A traditional brachioplasty was performed when contouring was needed only for skin laxity in the upper arm. Results Complications, such as hematomas or nerve injuries, were not evident. Some patients experienced partial wound dehiscence due to tension or hypertrophic scars found during the follow-up. In general, all of the patients were satisfied with the improvement in their upper arm contour. Conclusions Given the demands for body contouring surgery, the number of brachioplasty surgical procedures is expected to increase significantly, with abdominoplasty comprising a large portion of these surgeries. For the brachioplasty procedure, preparation and preoperative consultation regarding design of the surgery by experienced surgeons was important to prevent complications such as nerve damage or hematoma formation.

• Biomolecules & Therapeutics
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• 제30권2호
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• pp.126-136
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• 2022

Liver fibrosis is part of the wound healing process to help the liver recover from the injuries caused by various liver-damaging insults. However, liver fibrosis often progresses to life-threatening cirrhosis and hepatocellular carcinoma. To overcome the limitations of current in vivo liver fibrosis models for studying the pathophysiology of liver fibrosis and establishing effective treatment strategies, we developed a new mouse model of liver fibrosis using polyhexamethylene guanidine phosphate (PHMG-p), a humidifier sterilizer known to induce lung fibrosis in humans. Male C57/BL6 mice were intraperitoneally injected with PHMG-p (0.03% and 0.1%) twice a week for 5 weeks. Subsequently, liver tissues were examined histologically and RNA-sequencing was performed to evaluate the expression of key genes and pathways affected by PHMG-p. PHMG-p injection resulted in body weight loss of ~15% and worsening of physical condition. Necropsy revealed diffuse fibrotic lesions in the liver with no effect on the lungs. Histology, collagen staining, immunohistochemistry for smooth muscle actin and collagen, and polymerase chain reaction analysis of fibrotic genes revealed that PHMG-p induced liver fibrosis in the peri-central, peri-portal, and capsule regions. RNA-sequencing revealed that PHMG-p affected several pathways associated with human liver fibrosis, especially with upregulation of lumican and IRAK3, and downregulation of GSTp1 and GSTp2, which are closely involved in liver fibrosis pathogenesis. Collectively we demonstrated that the PHMG-p-induced liver fibrosis model can be employed to study human liver fibrosis.

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.308-313
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• 2020

Background: Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital. Methods: We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients' demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes. Results: A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%-38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%). Conclusion: Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

• Archives of Craniofacial Surgery
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• 제21권1호
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• pp.49-52
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• 2020

The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

• Archives of Plastic Surgery
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• 제35권1호
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• pp.67-72
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• 2008

Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.49-55
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• 2016

Purpose: Soft tissue defects in the lumbosacral area can be challenging to treat, and various methods to accomplish this have been proposed, including the use of perforator flaps. Herein, we present our experience with superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flaps for the reconstruction of lumbosacral defects. Materials and Methods: From March 2013 to July 2016, 28 cases (27 patients) of lumbosacral defects were treated by reconstruction with SGAP or IGAP flaps. The defects were caused by pressure sores (21 cases), burns (3 cases), tumor resection (2 cases), scars (1 case), or foreign body infection (1 case). Reliable perforators around the defect were found using Doppler ultrasound. The perforator flaps were elevated with a pulsatile perforator and rotated to cover the defects. Results: Twenty-three SGAP and 5 IGAP flap reconstructions were performed. The mean flap size was $9.2{\times}6.1cm^2$ (range, $5{\times}3cm^2$ to $16{\times}10cm^2$). Donor sites were closed by primary closure. Partial flap necrosis occurred in two cases, and minor complications of wound dehiscence occurred in 3 cases, which were healed by primary closure. The mean follow-up period was 4.4 months (range, 1~24 months). Conclusion: Gluteal-based perforator flaps can be safely harvested due to pliability and reliable vascularity in the gluteal area, reducing donor site morbidity without sacrificing the underlying muscles. Thus, these flaps are useful options for the reconstruction of lumbosacral defects.

• Journal of Korean Foot and Ankle Society
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• 제11권1호
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• pp.45-50
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• 2007

Purpose: To evaluate the short-term clinical outcomes of total ankle arthroplasty for the post-traumatic osteoarthritis. Materials and Methods: Fourteen patients who had undergone total ankle arthroplasty from February 2005 to June 2006 were reviewed. Eleven patients were male and three patients were female. The mean age was 52.8 years (range, 33 to 69 years). The mean follow-up duration was 15.9 months (range, 12 to 24 months). Primary injuries were pilon fractures in eight cases, malleolar fractures in three, ankle syndesmotic injury in one, talus fracture and dislocation in one, and distal tibial physeal injury in one. Visual analogue scale (VAS), Range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and complications were evaluated. Results: The mean VAS improved from 8.6 preoperatively to 2.6 at last follow-up. The mean ROM improved from 24.6 degrees preoperatively to 33.1 degrees postoperatively. The mean AOFAS score improved from 44.5 points preoperatively to 75.1 points postoperatively. Radiographically, all components were stable, but there were component malpositions in two cases, including one varus malposition of tibial component and one increased anterior translation of talar component. Complications were deep infection in one case, intraoperative malleolar fracture in three, marginal wound necrosis in two, and heterotopic ossification in one. One prosthesis was revised because of deep infection. Conclusion: Total ankle arthroplasty for the post-traumatic osteoarthritis is believed to be an useful method for preservation of the motion, relief of the pain and high satisfaction of patients in short-term results.

• Journal of Korean Foot and Ankle Society
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• 제22권1호
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• pp.26-31
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• 2018

Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.248-251
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• 2013

Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

• Journal of the Korea Society of Computer and Information
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• 제24권3호
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• pp.175-179
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• 2019

This study is a descriptive research of paramedic students who could be exposed to blood and body fluids during the clinical practicum to analyze the risk factors. From June 1 to June 30, 2018, 172 paramedic students who attended the University in Jeolla-do region were analyzed. The collected data were analyzed by using the SPSS WIN 21.0 program. The general characteristics of subjects, the exposure level of blood and body fluids, and etc were obtained for frequency and percentage analysis. The study found that 72.7 percent of students had experience to blood or body fluids exposure during the clinical practicum. Except for any needle injury, 70.4 percent of student were exposed to blood or body fluids. 28.8 percent of them which was the highest percentage of injection injury were exposed during the venous blood draw. 36.5 percent of exposure were related to wound dressings which was the highest percentage related to clinical procedures. 71.2 percent of students mentioned that they did not report this exposure because 68.5 percent students thought that it has no danger. According to the survey on hepatitis B, 50.6% of students had antibodies, but 31.8 percent of students did not confirm that the antibodies were formed. Even though paramedic students do practical training in a hazardous environment with repeated exposure to blood and body fluids due to the nature of job characteristics, the systemic infection control education program is insufficient. In order to prevent exposure and to protect paramedic students who do practical training with patients, it is necessary to make more systematic and active efforts in the continuous monitoring and the preventive education.