• Archives of Plastic Surgery
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• v.44 no.2
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• pp.109-116
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• 2017

Background The effect of liposuction on the perforators of the lower abdominal wall has been investigated in several studies. There are controversial results in the literature that have primarily demonstrated the number and patency of the perforators. The aim of this study was to determine the effect of liposuction on the perfusion of perforator-based abdominal flaps using a combined laser-Doppler spectrophotometer (O2C, Oxygen to See, LEA Medizintechnik). Methods Nine female patients undergoing classical abdominoplasty were included in the study. Perforators and the perfusion zones of the deep inferior epigastric artery flap were marked on the patient's abdominal wall. Flap perfusion was quantitatively assessed by measuring blood flow, velocity, capillary oxygen saturation, and relative amount of hemoglobin for each zone preoperatively, after tumescent solution infiltration, following elevation of the flap on a single perforator, and after deep and superficial liposuction, respectively. Results The measurements taken after elevation of the flap were not significantly different than measurements taken after the liposuction procedures. Conclusions The liposuction procedure does not significantly alter the perfusion of perforator-based abdominal flaps in the early period. The abdominal tissue discarded in a classic abdominoplasty operation can be raised as a perforator flap and has been demonstrated to be a unique model for clinical research.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.57-62
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• 2005

Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.179-183
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• 1984

In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-induced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptomas became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.452-456
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• 2012

Background Phosphatidylcholine (PPC) and deoxycholate (DCA) compound has been recently used for the purpose of partial lipolysis and is valued for its efficacy and lower invasiveness compared to liposuction and dermolipectomy used previously. In this article, the authors discuss the efficacy of the PPC dissolved in DCA via an experimental rat study model, along with suggesting a useful animal experimental model for the study of adipose tissue and lipolysis. Methods Bilateral inguinal fat pads of an experimental rat were elevated with the deep inferior epigastric vessel as the sole vascular pedicle. Normal saline was injected on one side as a control group and a PPC and DCA compound was injected on the other side. After 4 days, the rats were euthanized for microscopic tissue examination. The pathology was scored by a sem-iquantitative system in 4 categories: normal fat amount, fat necrosis, inflammatory activity, and stage of fibrosis. A Wilcoxon signed-rank test powered by SPSS packet program was used for statistical analysis and to determine significance. Results Microscopic examination was performed on the obtained samples, and the experimental data of all four categories showed significant histologic differences compared to the control group. All of the data also showed statistical significance by the Wilcoxon signed-rank test (P<0.01). Conclusions In the inguinal fat pad rat model, the control group and the experimental group had a differed significantly in the amount of normal fat tissue, inflammation, necrosis, and fibrosis. We recommend the rat inguinal fat pad model used in this study, as it is likely to be useful in related research.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1051-1062
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• 2019

Objectives: Chest pain presents diagnostic and therapeutic challenges because of its various etiologies. Many patients have chest pain from unknown causes and persistent chest pain in spite of standard treatment. The purpose of this study was to investigate the effectiveness of a Korean herbal medicine called Pyungjinsujeom-san (PSS) in relieving chest pain. Methods: We reviewed the electronic medical records of patients who visited the Korean Medical Clinic of Cardiology at Kyunghee University Hospital at Gangdong from January 2009 to July 2019, with the chief complaint of chest pain and who were treated with PSS. The mean severity of chest pain measured on the Numerical Rating Scale was compared before and after the administration of PSS. Results: The mean severity of chest pain of 20 patients decreased significantly from 6.80±1.61 to 1.35±0.9 after taking PSS (p<0.001). Most patients had symptoms of phlegm and food retention, including indigestion, postprandial fullness, and epigastric pain.Conclusions: These results suggest that PSS may be effective in relieving chest pain from various causes, particularly in patients with symptoms of phlegm and food retention.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.89-92
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• 2000

Acute gastric volvulus is uncommon but surgically emergent. Normally, the stomach is held in position by four ligaments: gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus and esophagus provides further anchorage. A normal diaphragm also helps to prevent abnormal displacement of abdominal viscera and development of gastric volvulus. Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial volvulus is the rotation of the stomach around an axis extending from the hiatus of the diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around an axis transecting the lesser and greater curvatures of the stomach. The symptoms of gastric volvulus depend on its type, the extent and degree of rotation and obstruction, and associated defects. Classic clinical features of acute gastric volvulus, as by Borchardt in 1904, include unproductive retching, acute, localized epigastric distention, and the inability to pass a NG tube. The presence and severity of these features depend on the degree of gastric obstruction of both the gastroesophageal junction and pyloric outlet. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to avoid recurrence, and correction of any underlying anatomic abnormality. Any associate defect should be repaired and the stomach must be fixed. The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric volvulus.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.301-304
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• 2007

A 33-year-old man presented to the physician with epigastric discomfort. Computed tomography of the chest and echocardiography showed a mass in the left atrium; this mass was resected and diagnosed as myxoma. 12 months later, myxoma recurred in the right atrium, and it was resected without recurrence for 10 months until now. As there are only a few reports on recurred right atrial myxoma after left atrial myxoma, we report here on successful surgical removal of a recurred right atrial myxoma after resection of left atrial myxoma.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.546-549
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• 2010

A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.172-180
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• 2016

Background: Ischemic heart disease is the most common type of heart disease and an important cause of death in Korea. Among marketed anti-anginal medications, molsidomine, nicorandil, and trimetazidine are approved in Korea with unique mechanism of actions. As these drugs are not approved by the US Food and Drug Administration, the access to the up-to-dated and comprehensive safety-related information has been less than optimal from drug information resources used by Korean pharmacists. Methods: A systematic review was conducted using Embase and Korean manuscripts to compile safety updates for these medications. Out of 418 articles from keyword searches, 52 studies were reviewed in full to compare adverse effects (AEs) with the approved package inserts (PI). Results: Molsidomine related adverse effects were mostly mild or moderate, but anxiety, palpitation, epigastric pain, and sexual potency reduction were additional AEs found from the review not listed in PI. Although PI has included ulceration in oral cavity and gastrointestinal tracts including anus by nicorandil, the Korea FDA recently recommended adding corneal, genital, and skin ulcers to the approved PI. Trimetazidine induced Parkinsonism, worsening of the symptoms for patients diagnosed with Parkinson's disease, gastrointestinal burning, and muscle cramps were additionally identified AEs not listed in PI for trimetazidine. Conclusion: Continuous evaluations of the safety profile of these agents are needed to balance the risks and benefits to provide evidence-based safety counseling to the patients. In addition, more focused efforts on spontaneous reporting are warranted by healthcare professionals to safeguard patients against AEs.

• Journal of Gastric Cancer
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• v.16 no.4
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• pp.266-270
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• 2016

We report a unique case of synchronous double primary gastric cancer consisting of adenocarcinoma components with micropapillary features and composite glandular-endocrine cell carcinoma components. The patient was a 53-year-old man presenting with a 6-month history of epigastric pain and diarrhea. A subtotal gastrectomy was performed. Histologically, one tumor was composed of micropapillary carcinoma components (50%) with tight clusters of micropapillary aggregates lying in the empty spaces, admixed with moderately differentiated adenocarcinoma components. MUC-1 was expressed at the stromal edge of the micropapillary component. The other tumor was composed of atypical carcinoid-like neuroendocrine carcinoma (50%), adenocarcinoid (30%), and adenocarcinoma components (20%). The neuroendocrine components were positive for CD56, synaptophysin, chromogranin, and creatine kinase. The adenocarcinoid components were positive for both carcinoembryonic antigen and neuroendocrine markers (amphicrine differentiation). This case is unique, due to the peculiar histologic micropapillary pattern and the histologic spectrum of adenocarcinoma adenocarcinoid-neuroendocrine carcinoma of the synchronous composite tumor.