• Archives of Plastic Surgery
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• 제43권2호
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• pp.189-196
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• 2016

Background Several techniques have been designed to treat fifth metacarpal fractures reported to be effective. However, these methods cannot be easily applied to the fourth metacarpal due to its central anatomical position. In this study, we sought to analyze the functional outcomes of patients who underwent transverse pinning for a fourth metacarpal bone fracture. Methods A total of 21 patients were selected and their charts were retrospectively reviewed. After fracture reduction, two transverse Kirchner wires were first inserted from the fifth metacarpal to the third metacarpal transversely at the distal part of the fractured bone, and then another two wires were inserted at the proximal part of the fractured bone. The splint was removed approximately one week postoperatively and the Kirchner wires were removed four to five weeks postoperatively. Patients started active and passive exercise one week after the operation. Pain visual analog scores, total active and passive motion, and the active and passive range of motion of the metacarpophalangeal joint and grip strength were evaluated. Results Dorsal angulation improved from a preoperative value of $44.2^{\circ}$ to a postoperative value of $5.9^{\circ}$. Six weeks after surgery, functional recovery parameters, such as range of motion and grip strength, had improved to 98% of the function of the normal side. No major complication was observed. Conclusions We suggest that the transverse pinning of fourth metacarpal bone fractures is an effective treatment option that is less invasive than other procedures, easy to perform, requires no secondary surgery, minimizes joint and soft tissue injury, and allows early mobilization.

• ALGAE
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• 제30권3호
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• pp.197-205
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• 2015

The genus of leafy green algae, Prasiola Meneghini, includes marine, terrestrial, and freshwater species. A total of 11 species and one variety have been identified in China, Korea, and Japan. In Korea, Prasiola formosana var. coreana has been reported in Muncheon, North Korea, while a different type of Prasiola species has been reported in South Korea. The South Korean species has been found growing along a small stream originating from Chodanggul Cave, a limestone cave in Samcheok, Gangwon Province. Here, we revised the morphological characteristics of the South Korean Prasiola species and analyzed plastid rbcL, psaB, and tufA genes to clarify its identity. Although the external and anatomical morphologies varied among individuals, our results were very similar to previous reports. Plastid three genes sequences of the South Korean specimens were identical to those of P. japonica collected from Japan as well as to published sequences of P. yunnanica from China. A short rbcL-3P sequence (196 bp) from P. formosana var. coreana, which was identified in the type specimen, was also identical to a sequence from P. japonica. These Prasiola species and variety from Korea, Japan, and China are all distributed in areas characterized by limestone bedrock. Based on morphological, phylogenetic, and distributional features, the South Korean Prasiola species is regarded herein as P. japonica. Here, we also propose to synonymize P. formosana var. coreana and P. yunnanica with P. japonica.

• The Korean Journal of Pain
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• 제26권4호
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• pp.336-346
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• 2013

Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.

• Nuclear Engineering and Technology
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• 제6권4호
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• pp.239-247
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• 1974

방사선 안전관리의 효과적인 연구를 위해 유사인체 모형을 설계, 제작하였다. 이 모형의 치수는 한국인의 체격과 근사하게 맞추었으며 두께 2.5cm인 포리에칠렌판 35매로 구성되었다. 유사인체모형의 표면에 착용한 열형광 설량계(Disc type TLD)로써 외부 ${\gamma}$-방사선에 의한 신체특정부위의 피폭선량을 측정하였으며, 아울러 깊이에 따른 흡수선량에 대해서 열형광 선량계(micro rod type TLD)로써 측정하여 결정장기 부위의 각단면에 대한 등가선량선을 얻었다. 선량측정은 방사선 작업자의 작업환경조건에 유사하도록 유사인체 모형에 대해 배치하고 여러 입사방항에 대해서 실시하였다. 그 결과 Cs-137, ${\gamma}$-방사선에 대하여 두께 20cm인 유사인체 모형에서의 감쇄는 0.439였으며 이는 보고된 자료들과 잘 일치하였다.

• Journal of Chest Surgery
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• 제28권6호
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• pp.533-541
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• 1995

We recently developed a new model of moving actuator type totally implantable artificial heart[TIAH , based on the reverse position of the aortic and pulmonary conduits. This concept was proposed by one of surgeons in our team[Joon-Ryang Rho, M.D. to facilitate anatomical fitting of TIAHs. The moving actuator type electromechanical TIAH consisted of the left and right blood sacs, and the moving actuator including a motor. The inverted umbrella type polyurethane valves were used in the blood pumps. The aortic conduit was positioned anterior to the pulmonary conduit, which was the opposite relation to the conventional configuration of other total artificial hearts. We also adapted slip-in connectors for the aortic and pulmonary conduits. Two sheep , weighing 60-69 kg, were used for implantation. After small cervical incision and trans-sternal bilateral thoracotomy, cardiopulmonary bypass [CPB was administered using an American Optical 5-head pump and a membrane oxygenator[Univox-IC, Bentley . The anterior and posterior vena cavae were drained separately for venous return. An arterial return cannula was inserted into the right common carotid artery. During CPB, almost all of the ventricular myocardium was excised down to the atrioventricular groove and the artificial heart was implanted. We achieved 3-day survival in the first sheep and 2-day survival in the second. The day after operation the first sheep was successfully extubated and the second sheep was weaned from a respirator with good condition. After extubation, the first sheep walked around in the cage and fed herself. Serial laboratory and hemodynamic examinations were done during the experiments. In both sheep, pulmonary dysfunction was gradually developed, which was accompanied by acute renal failure. The animals were sacrificed and autopsy was done. Unexpected pregnnacy was incidentally found in both sheep. To our knowledge this is the first report of significant survival cases in the orthotopic implantation of electric TIAH using sheep.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.235-240
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• 2011

Purpose: Management of pressure sores has been improved, along with development of musculocutaneous flaps and perforator flaps. Nowadays, the treatment of pressure sore with perforator flaps has shown several advantages, including minimal donor site morbidity, relatively versatile flap design not only in primary cases but also in recurred cases and minimized anatomical rearrangement of regional muscle position. In this study, we report our clinical experience of gluteal perforator flap used in the treatment of a greater trochanteric pressure sore. Methods: A clinical study was performed on 7 patients who underwent total 10 operations. 1 superior gluteal artery perforator flap and 9 inferior gluteal artery perforator flaps were used to reconstruct the defect, followed by the mean observation duration of 22 months. Results: There were no total flap loss. We treated 2 cases of partial flap loss with debridement and primary repair. 2 recurred cases were successfully treated using the same method. Donor sites were all primarily repaired. Conclusion: The gluteal perforator flap could be considered as a safe and favorable alternative in the treatment of soft tissue defects in the greater trochanteric area. The advantages of the flap include low donor site morbidity and the possibility of versatile flap design not only in primary cases but also in recurred cases.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.275-279
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• 2013

Objective : This study was designed to determine the most reliable cephalometric measurement technique in the normal population and patients with basilar invagination (BI). Methods : Twenty-two lateral radiographs of BI patients and 25 lateral cervical radiographs of the age, sex-matched normal population were selected and measured on two separate occasions by three spine surgeons using six different measurements. Statistical analysis including intraclass correlation coefficient (ICC) was carried out using the SPSS software (V. 12.0). Results : Redlund-Johnell and Modified (M)-Ranawat had a highest ICC score in both the normal and BI groups in the inter-observer study. The M-Ranawat method (0.83) had a highest ICC score in the normal group, and the Redlund-Johenll method (0.80) had a highest ICC score in the BI group in the intra-observer test. The McGregor line had a lowest ICC score and a poor ICC grade in both groups in the intra-observer study. Generally, the measurement method using the odontoid process did not produce consistent results due to inter and intra-observer differences in determining the position of the odontoid tip. Opisthion and caudal point of the occipital midline curve are somewhat ambiguous landmarks, which induce variable ICC scores. Conclusion : On the contrary to other studies, Ranawat method had a lower ICC score in the inter-observer study. C2 end-plate and C1 arch can be the most reliable anatomical landmarks.

• 대한한의학원전학회지
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• 제33권2호
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• pp.91-108
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• 2020

Objectives : To study the shu points selection of the Four Seas in the 「Hailun」 chapter of 『Lingshu』. Methods : The effects and main indications of each shu point, their anatomical position, characteristics along with similarities of disease patterns according to excessiveness and deficiency of the Four Seas were examined. Results : The selection of shu points of the Four Seas were deeply related to the effects and main indications, and the common similarity among conditions due to excessiveness and deficiency was the presence of psychological aspects. Also, when the Four Seas are connected to the Jing-Qi-Shen and Blood, marrow sea[髓海] is connected to Jing & Shen, qi sea[氣海] is connected to Qi, blood sea[血海] is connected to Blood, and sea of water and grain[水穀之海] replenishes Jing-Qi-Shen and Blood. When connected to the Four Qi Intersections, the marrow sea is connected to 'head qi with intersection', qi sea is connected to 'chest qi with intersection', sea of water and grain or blood sea is connected to 'stomach qi with intersection', otherwise sea of water and grain is connected to 'shin qi with intersection'. Conclusions : The Four Seas are designated to the shu points due to their accumulation of Qi when the main elements of Jing-Qi-Shen and Blood are deficient or excessive, allowing for the most convenient management and manipulation of the condition of these main elements. In clinical practice, the shu points of the Four Seas will likely increase treatment efficacy for conditions that include psychological aspects.

• The Korean Journal of Pain
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• 제23권4호
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• pp.242-246
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• 2010

Background: The first sacral nerve root block (S1NRB) is a common procedure in pain clinic for patients complaining of low back pain with radiating pain. It can be performed in the office based setting without C-arm. The previously suggested method of locating the needle entry point begins with identifying the posterior superior iliac spine (PSIS). Then a line is drawn between two points, one of which is 1.5 cm medical to the PSIS, and the other of which is 1.5 cm lateral and cephalad to the ipsilateral cornu. After that, one point on the line, which is 1.5 cm cephalad to the level of the PSIS, is considered as the needle entry point. The purpose of this study was to analyze the location of needle entry point and palpated PSIS in S1NRB. Methods: Fifty patients undergoing C-arm guided S1NRB in the prone position were examined. The surface anatomical relationships between the palpated PSIS and the needle entry point were assessed. Results: The analysis revealed that the transverse and vertical distance between the needle entry point and PSIS were $28.7{\pm}8.8mm$ medially and $3.5{\pm}14.0mm$ caudally, respectively. The transverse distance was $27.8{\pm}8.3mm$ medially for male and $29.5{\pm}9.3mm$ medially for female. The vertical distance was $1.0{\pm}14.1mm$ cranially for male and $8.1{\pm}12.7mm$ caudally for female. Conclusions: The needle entry point in S1NRB is located on the same line or in the caudal direction from the PSIS in a considerable number of cases. Therefore previous recommended methods cannot be applied to many cases.