• Journal of Korean Foot and Ankle Society
• /
• v.6 no.1
• /
• pp.21-27
• /
• 2002

Pressure sores are an ulceration and necrosis of the skin and underlying tissue usually occur after prolonged or repeated pressure by interruption of blood flow from the small. vessels to the skin and deep tissue. The management of pressure sores is mostly difficult and requires prolonged hospitalization or repeated surgical interventions with a high recurrence rate. In this article we reviewed 14 cases of National Pressure Ulcer Advisory Pannel staging III, IV over the lateral malleolar area of the ankle in 2 years period from January 1999 to October 2001. The pressure over lateral malleolar area was mainly due to unique Korean sitting position with cross legs at flexed hips and knees or supine position of patient with external rotation of low extremity. Male to female ratio was 11: 3 and ages were between 36 and 83 (mean age: 67.1 years). Associated diseases were DM(7 cases), Hemiparesis caused by CVA(2 cases), Liver cirrhosis(2 cases), disarticulation of opposite hip due to squamous cell ca.(1 case), Intertrochanteric Fx.(1 case). Wound cultures reported Staphylococus, Pseudomonas and others. Abnormally elevated ESR and CRP were seen in 6 cases. Operative treatments were irrigation and debridement, direct closure with gravity drainage and skin grafting. The most important aspect of pressure sore treatment is pressure relief of the lateral malleolar area. Pressure-relieving Cast or Brace was helpful for local management and preventing recurrence.

• IMMUNE NETWORK
• /
• v.14 no.5
• /
• pp.255-259
• /
• 2014

Physical activity could be considered one of the factors that affect the immune system status and function. To find the relation between exercise and cytokines, we examined the possible effects of an 8-week endurance training program on the serum levels of cytokines, including tumour necrosis factor-alpha (TNF-${\alpha}$) and interferon-gamma (IFN-${\gamma}$) in sedentary men. A total of 30 healthy young male volunteers were randomly divided into an endurance training group and a control group. The training group followed a specific exercise protocol (running on a treadmill for 15~30 min at 50~70% maximal heart rate) for 8 weeks and the control group did not participate in any exercise program. Venous blood samples were collected from both the groups 24 h before and 24 h and 48 h after the exercise. Repeated ANOVA was used for statistical purposes. The serum levels of TNF-${\alpha}$ and IFN-${\gamma}$ were determined by ELISA. Significant (p<0.05) and non-significant (p>0.05) decreases were observed in the serum levels of IFN-${\gamma}$ and TNF-${\alpha}$, respectively, after the 8-week endurance training program. Our findings indicated that an 8-week endurance exercise may affect the serum levels of some inflammatory cytokines, suggesting the beneficial role of this training protocol in elderly population and people with certain conditions (inflammation of the vertebrae or other inflammatory diseases).

• Archives of Plastic Surgery
• /
• v.38 no.1
• /
• pp.121-126
• /
• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• Journal of Digital Convergence
• /
• v.16 no.2
• /
• pp.19-26
• /
• 2018

We proposed a numerical calculation of the proportion of necrotic cells in pulmonary segmentation, pulmonary vessel segmentation lung disease site for diagnosis of lung disease from chest CT images. The first step is to separate the lungs and bronchi by applying a three-dimensional labeling technique from a chest CT image and a three-dimensional region growing method. The second step is to divide the pulmonary vessels by applying the rate of change using the first order polynomial regression, perform noise reduction, and divide the final pulmonary vessels. The third step is to find a disease prediction factor in a two-step image and calculate the proportion of necrotic cells.

• Archives of Reconstructive Microsurgery
• /
• v.20 no.1
• /
• pp.1-7
• /
• 2011

The aim of extremity reconstruction has focused on early wound coverage and functional recovery but rarely aesthetics. As the quality of life improves, however, the request for aesthetics has been growing. The authors has conducted retrospective reviews on the 86 cases that had extremity reconstruction using free flap, considering the characteristics of parts that had been assessed in primary operation between May 1996 and December 2010. Aesthetic grading was performed in four categories; color, texture, contour and marginal scar. Recipient sites were 42 hands, 19 feet, 14 lower extremities excluding feet and 10 upper extremities apart from the hand. Types of free flap were 16 latissimus dorsi free flaps, 13 anterolateral thigh free flaps, 12 dorsalis pedis free flaps, 8 transvers rectus abdominis free flaps, 7 gracillis free flaps, and 5 superficial temporal fascia free flaps. Total flap necrosis was seen in 8 cases(9.3%) and partial necrosis in 5 cases(5.8%). Secondary revision was done in 24 cases(27.9%) and the most common revision, debulking was done in 14 cases(16.3%). The authors has considered cosmetic aspects along with wound coverage and functional recovery in primary reconstruction. The results of aesthetic grading was 16.2 out of 20, and the secondary revision rate was reduced.

• Journal of Korean Foot and Ankle Society
• /
• v.1 no.2
• /
• pp.119-125
• /
• 1997

The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.

• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.220-225
• /
• 2013

Background A recent advancement in microsurgery, the free flap is widely used in the reconstruction of the lower leg and foot. The simple and effective methods of local flaps, including transposition and advancement flaps, have been considered for patients with chronic debilitation who are unable to endure long surgical procedures or general anesthesia. However, the location and size of the wound may restrict the clinical application of a local flap. Under these circumstances, a sural flap can be an excellent alternative, rendering satisfying clinical outcomes in chronically debilitated patients. Methods Between 2008 and 2012, 39 patients underwent soft tissue defect treatment by sural artery flap as a final method. All of the patients had at least one chronic disease or more (diabetes, hypertension, vascular disease, etc.). Also, all of the patients had a history of chronic lower extremity ulceration, which revealed no response to several months of conservative treatment. Results The results of the 39 cases had a success rate of 100% with 39 complete recoveries. Nine cases suffered complications: partial necrosis (n=4), wound dehiscence without necrosis (n=3), hematoma (n=1), and infection (n=1). Conclusions The sural artery flap is not only useful for the lower leg but also for the heel, and other various parts. Furthermore, it is a relatively simple surgical technique for reconstructing the defect area for patients with various chronic conditions with a high surgical risk or contraindications to surgery.

• Archives of Reconstructive Microsurgery
• /
• v.13 no.2
• /
• pp.107-116
• /
• 2004

Flaps are necessary, when important structures such as bone, tendon, nerve and vessel are exposed. Arterialized venous free flap is suited to the coverage of finger and hand because the thickness of venous flap is thin. Authors performed 65 cases arterialized venous free flap for the soft tissue reconstruction of the hand and finger. The size of donor defect were from $1{\times}1cm\;to\;7{\times}12cm$. The mean flap area was $9.1cm^2$. The recipient sites were finger tip in 34 cases, finger shaft in 29 cases and hand in 2 cases. The donor sites were volar aspect of distal forearm in 40 cases, thenar area in 17 cases and foot dorsum in 6 cases. The types of arterialized venous free flap were A-A type in 4 cases and A-V type in 61 cases. The length of afferent vein was from 0.5 cm to 3 cm (mean 1.7 cm) and efferent vein was from 1 cm to 10 cm (mean 2.2 cm). 58 flaps(89.2%) survived eventually. 42 flaps(64.6%) survived totally without any complication. 8 flaps(12.3%) showed the partial necrosis but they were healed without any additional operations. 8 flaps (12.3%) showed the partial necrosis requiring the additional skin graft. We had a satisfactory result by using arterialized venous free flap for the soft tissue reconstruction of finger and hand. We believe that volar aspect of distal forearm, thenar area, foot dorsum are suited as a donor site and the short length of the flap pedicle, the strong arterail inflow affect the survival rate of arterialized venous free flaps.

• Korean Journal of Veterinary Service
• /
• v.41 no.2
• /
• pp.91-95
• /
• 2018

Polioencephalomalacia (PEM) is a neurologic disease of ruminants diagnosed by pathological approach. There is very little information available to understand bovine PEM in Korea. In this study, we investigated the diagnostic rate and pathological features of PEM in 334 necropsied cases of cattle submitted to the Animal and Plant Quarantine Agency in Korea from 2015~2017. PEM was diagnosed only in 13 (3.9%) Hanwoo, the Korean native cattle, and sporadically occurred in our country. The disease was the most diagnosed in fall season, and the age of the cows ranged from 1 month to 3 year. In all PEM cases, softening, and yellow discoloration of the gray matter in the cerebrum and fluorescence at the sites using ultraviolet illumination were grossly observed. Microscopically abundance of glial cells with vacuolar large cytoplasm and neuronal necrosis were commonly observed. This study suggests that future studies are necessary to identify the cause and pathogenesis for the control of PEM in our country.

• Korean Journal of Optics and Photonics
• /
• v.23 no.3
• /
• pp.108-112
• /
• 2012

In this paper, two wavelengths mainly used for laser prostatectomy have been quantitatively compared: 532 and 980 nm. Two lasers at 40 W were employed to ablate bovine liver in vitro. Ablation performance was evaluated in light of number of sweeps, ablation volume, and coagulative necrosis. 532 nm yielded up to four times higher ablation efficiency than 980 nm. Regardless of wavelength, ablation rate per sweep decreased with the number of sweeps. 532 nm generated relatively deeper ablation craters along with thinner coagulation whereas 980 nm created superficial tissue ablation with up to 2 mm thick coagulative necrosis. Due to higher light absorption and effective thermal confinement, 532 nm induced more efficient tissue ablation with a smaller coagulative necrotic zone. The current study demonstrated that 532 nm could be a more ideal wavelength for laser prostatectomy, and the future in vivo investigations will confirm these findings.