• 대한두개안면성형외과학회지
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• 제24권1호
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• pp.37-40
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• 2023

Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

• 한국임상수의학회지
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• 제40권1호
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• pp.25-30
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• 2023

The ventral midline approach (VMA) and right flank approach (RFA) are common procedures for the sterilization of bitches. This study compared the different parameters viz. total duration of surgery, recovery time, and length of the incision as well as body temperature, heart rate, respiration rate, and SpO2 in each approach. Twenty (20) bitches were divided randomly for the RFA and VMA. Meloxicam (0.2 mg/kg) was administered subcutaneously half an hour before the induction to provide preemptive analgesia. Diazepam and ketamine were administered intravenously at dose rates of 0.25 mg/kg and 2.5 mg/kg, and 0.17 mg/kg and 3.33 mg/kg, respectively to produce and maintain anesthesia. Each parameter was recorded at the pre-operative, operative and post-operative times. The average duration of surgery and length of incision of RFA (16.1 ± 5.13 min and 2.44 ± 0.83 cm) were significantly lower (p < 0.05) than the VMA (21.3 ± 5.48 min and 3.53 ± 0.7 cm). The operated bitches showed hypothermia (p < 0.05) at 1 hour compared to baseline and 24 hours of surgery. Heart and respiration rates increased significantly (p < 0.05) during traction and severing of ovarian ligaments in bitches within the RFA group, but there was no significant difference within VMA approaches. The sedation score was significantly higher (p < 0.05) at 1 hour after surgery in both approaches. Based on the duration of surgery and length of incision RFA approach was quick and minimal skin wound. Further studies on bitches considering molecular investigations of surgical stress are imperative.

• 분석과학
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• 제36권3호
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• pp.128-134
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• 2023

병풀(Centella asiatica) 추출물인 asiaticoside와 madecassoside는 항균성 및 피부재생 등의 효과로 인해 아시아 지역에서 치료용 연고에 사용되고 있으며, 병풀의 재배 및 추출효율을 높이기 위한 연구가 상업화를 위해 활발히 진행되고 있다. 본 연구에서는 환경 친화적인 추출 용매인 deep eutectic solvents(DESs)가 병풀에서 asiaticoside와 madecassoside의 추출 효율에 미치는 영향을 관찰하기 위하여 다양한 수소결합 받개(hydrogen bond acceptor, HBA)와 주개(hydrogen bond donor, HBD)의 혼합 몰비(HBA1: HBD2, HBA1:HBD3, HBA1:HBD4, 그리고 HBA1:HBD5)로 제조하여 추출용매로 사용하였며, 용매 추출에서 일반적으로 사용되고 있는 추출용매인 증류수(DW)와 methanol (MeOH)의 추출 결과를 최적화된 HPLC조건으로 분리하여 정량 분석하였다. 그 결과, DW와 DES를 3:7로 혼합하여 사용한 경우가 단일 MeOH를 사용한 경우보다 약 1.4배 높은 추출 효율을 보였다. 반대로 MeOH과 DES를 3:7로 혼합하여 사용하는 경우에서는 단일 MeOH를 사용하는 경우보다 약 6 % 낮은 추출 효율을 보였다.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.535-540
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• 2023

Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m²; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.

• 대한화장품학회지
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• 제44권3호
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• pp.349-362
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• 2018

한련초는 열대 및 아열대 지방에 서식하는 국화과 한련초속에 속하는 한해살이풀로 간 손상에 대한 보호효과, 살무사 독에 대한 해독효과, 항산화효과, 발모효과, 상처치유효과 등의 효능들이 확인된 바 있다. 더 나아가 본 연구에서는 한련초의 항산화 및 항노화효과를 확인하여 피부보호 소재로써의 가능성을 검토하고자 하였다. 이를 위해 한련초를 50% 에탄올로 추출한 추출물과 이를 다시 에틸아세테이트로 분획하여 얻은 분획물을 실험에 사용하였다. 항산화 지표인 $FSC_{50}$과 $OSC_{50}$을 측정한 결과, 에틸아세테이트 분획물의 $OSC_{50}$은 항산화제로 잘 알려진 L-ascorbic acid 보다 2.7배 이상 뛰어난 것으로 나타났다. 이와 더불어 시료의 세포 내 활성산소종 소거능과 $H_2O_2$로 유도된 세포손상에 대한 보호효과가 확인되었으며, 특히 $^1O_2$으로 유도된 사람 적혈구 광용혈에 대한 지연효과의 평가에서 $64{\mu}g/mL$의 에틸아세테이트 분획물이 적혈구 광용혈의 소요시간을 6배 이상 지연시켜 한련초의 우수한 항산화능을 반영해주었다. 한련초의 항노화 효과를 검증하기 위해 Hs68에서 추출한 엘라스타제에 대한 저해활성을 평가한 결과, $16{\mu}g/mL$의 두 시료 모두 엘라스타제의 활성을 각각 6.8%와 14.0% 억제한 것을 확인하였다. 마지막으로 한련초가 식품 또는 화장품 등의 소재로 사용됨에 있어 화학적 방부제의 역할을 대체할 수 있을 가능성을 확인하기 위한 항균실험의 결과, 에틸아세테이트 분획물이 그람 양성 균주인 Staphylococcus aureus에 대해 mehyl paraben과 동등하거나 더 뛰어난 항균활성을 가진 것을 확인하였다. 이상의 실험결과들을 통해 한련초는 피부보호 소재 또는 천연방부제로서의 가능성을 가진 천연소재라 생각되며, 식품 또는 화장품 소재로서의 이용이 기대된다.

• Journal of Chest Surgery
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• 제31권5호
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• pp.466-471
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• 1998

연구목적: 소아연령군에서의 최소침투적심장수술의 적용가능성 여부와 안전성 및 효율성 등을 검증해 보기 위해 본연구를 시행하였다. 대상환아) 1997년 7월부터 1997년 11월까지 본 서울대학교병원 어린이병원 흉부외과에서 최소침투적심장수술을 받은 46례의 환아를 대상으로 하였으며 환아의 평균 연령 및 체중은 각각 34.6$\pm$41.8 (범위:1~148) 개월, 14.5$\pm$9.9 (범위:3.0~40.0) kg였다. 28명의 환아가 남아였으며 술전 진단은 15례의 심방중격결손증, 25례의 심실중격결손증 (이중 16례는 막주변형이었고 1례는 대동맥판하 막성협착을 동반함), 1례의 대동맥내 이물, 3례의 부분방실중격결손증, 1례의 전폐정맥연결이상 (심장형), 1례의 활로씨사징증이었다. 수술방법 : 상흉골함요(陷凹)로부터 가능한 하부로 멀리 떨어져 정중피부절개를 가한후, 하부흉골을 노출시켰다. 검상돌기부터 정중흉골절개를 시작하여 제 2늑간 수준까지 연장한 후, 흉골의 한쪽 또는 양쪽에 횡절개를 가하여 T형, J형, I형 또는 역 C형 흉골절개가 되게하여 우측 또는 양측 들창모양의 흉골개구부를 확보하였다. 삽관을 대동맥과 상,하공정맥에 일반적인 방법으로 시행하고, 질환별 수술방법 역시 통상적인 방법에 의해서 시행되었다. 결과 : 평균 피부절개의 길이는 6.1$\pm$1.0 (범위:4.0~9.0) cm였고 상흉골함요와 피부절개상단사이의 거리는 평균 4.0$\pm$1.1 (범위:2.0-7.0) cm였다. 평균심폐우회시간, 대동맥차단시간, 및 총수술시간은 각각 62.9$\pm$20.0 (범위:28~147), 29.8$\pm$12.8(범위:11~79), 161.1$\pm$34.5(범위:100~250) 분이었다. 수술후 수혈총량은 평균 71.0$\pm$68.1 (범위: 0~267) cc였으며 환아는 평균 11.3$\pm$13.8 (범위:1-73) 시간후에 인공호흡기이탈이 가능하였다. 진통제로는 평균 0.8$\pm$1.8 (범위: 0~9) mg 용량의 모르핀이 사용되었으며 환아는 평균 35.0$\pm$32.2 (범위: 10~194) 시간동안 중환자실 관리가 필요했고 평균 재원기간은 6.2$\pm$2.0 (범위: 3~11) 일이었다. 상흔관련 합병증 및 수술사망례는 발생하지 않았다. 결론: 비록 단기간의 관찰이었지만 본연구를 통해 저자등은 소아연령군에서 일부 선천성 심질환에 대하여 최소침투적심장수술의 적용의 가능성 및 유용성을 입증하였으며 특히 미용효과면에서 탁월하다는 사실을 발견하였다.

• 한국의료질향상학회지
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• 제4권1호
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• 생명과학회지
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• 제30권10호
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• pp.877-885
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• 2020

표고버섯에는 다양한 효능성분들이 존재하며 특히, β-glucan과 polyphenol 성분들은 항산화, 광노화, 주름개선 등의 피부개선 효능이 알려져 있다. 본 연구에서는 표고버섯 물 추출물에서 polyphenol과 β-glucan 함량을 확인하였으며 이러한 연구결과를 바탕으로 피부노화 억제효능을 조사하였다. Scratch wound healing assay를 통해 표고버섯 물 추출물 처리시 자외선 조사에 의해 손상된 HaCaT cell의 증식 유도 효과를 확인하였다. 또한 세포 내 생성된 ROS를 효과적으로 소거함으로써 세포 내 과도한 산화 스트레스를 줄여 다양한 염증성 사이토카인의 유발을 억제하고 피부노화 인자의 발현을 억제하는 것으로 생각된다. 세포 외 기질과 단백질을 분해하는 MMPs의 발현양상을 확인한 결과 표고버섯 물추출물은 MMP-1과 MMP-9의 발현을 억제하였으며, type I collagen의 생합성을 증가시켰다. 이를 통해 표고버섯 물 추출물은 세포를 활성화시켜 세포의 이동 및 증식을 유도함으로써 피부를 재생 및 collagen 합성을 촉진하고 collagen 분해 인자를 억제시킴으로써 피부의 주름억제 활성에 효능을 가지는 것으로 확인되었다. 따라서 본 연구를 통해 표고버섯 물 추출물은 화장품 분야에서 피부 노화 예방 및 개선소재로서의 개발 가능성을 확인하였다.

• Journal of Chest Surgery
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• 제32권5호
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• pp.438-441
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• 1999

배경: 최소 침습성 심장수술은 기존의 정중 흉골절개술보다 우수한 미용효과, 흉곽 개폐에 있어서의 용이함, 작은 외상에 따른 통증, 감염, 출혈 등의 감소, 빠른 회복 및 재원일수의 감소 등이 장점으로 제시되면서 점차 널리 시행되고 있다. 대상 및 방법: 저자들은 1997년 3월부터 12월 까지 36명의 환자를 대상으로 우측 방정중 절개법, 흉골횡 절개법, 최소흉골절개법 등의 3가지 접근방법으로 대동맥 판막 및 승모판 판막질환, 선천성 심기형의 환자 등에 대해 최소 침습성 심장수술을 시행하였다. 결과: 사망례는 없었다. 합병증으로는 술후 부정맥 4례, 출혈로 인한 재수술 1례, 창상 지연유합 1례가 있었다. 사용된 창상의 평균 길이는 9.1$\pm$0.9cm이었고 중환자실 체류기간은 평균 48$\pm$29시간, 술후 재원기간은 평균 10$\pm$7일 이었다. 결론: 술중 제세동, 탈기, 심장감압 등의 과정에 있어서 어려운 점이 있고 아직까지는 선별된 예에 한해 시행되고 있으나 경험의 축적에 따라 점차 그 적용례가 늘어날 것이라 전망된다.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.564-569
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• 2016

Objective : This study used the intradural procedural time to assess the overall technical difficulty involved in surgically clipping an unruptured middle cerebral artery (MCA) aneurysm via a pterional or superciliary approach. The clinical and radiological variables affecting the intradural procedural time were investigated, and the intradural procedural time compared between a superciliary keyhole approach and a pterional approach. Methods : During a 5.5-year period, patients with a single MCA aneurysm were enrolled in this retrospective study. The selection criteria for a superciliary keyhole approach included : 1) maximum diameter of the unruptured MCA aneurysm <15 mm, 2) neck diameter of the MCA aneurysm <10 mm, and 3) aneurysm location involving the sphenoidal or horizontal segment of MCA (M1) segment and MCA bifurcation, excluding aneurysms distal to the MCA genu. Meanwhile, the control comparison group included patients with the same selection criteria as for a superciliary approach, yet who preferred a pterional approach to avoid a postoperative facial wound or due to preoperative skin trouble in the supraorbital area. To determine the variables affecting the intradural procedural time, a multiple regression analysis was performed using such data as the patient age and gender, maximum aneurysm diameter, aneurysm neck diameter, and length of the pre-aneurysm M1 segment. In addition, the intradural procedural times were compared between the superciliary and pterional patient groups, along with the other variables. Results : A total of 160 patients underwent a superciliary (n=124) or pterional (n=36) approach for an unruptured MCA aneurysm. In the multiple regression analysis, an increase in the diameter of the aneurysm neck (p<0.001) was identified as a statistically significant factor increasing the intradural procedural time. A Pearson correlation analysis also showed a positive correlation (r=0.340) between the neck diameter and the intradural procedural time. When comparing the superciliary and pterional groups, no statistically significant between-group difference was found in terms of the intradural procedural time reflecting the technical difficulty (mean${\pm}$standard deviation : $29.8{\pm}13.0min$ versus $27.7{\pm}9.6min$). Conclusion : A superciliary keyhole approach can be a useful alternative to a pterional approach for an unruptured MCA aneurysm with a maximum diameter <15 mm and neck diameter <10 mm, representing no more of a technical challenge. For both surgical approaches, the technical difficulty increases along with the neck diameter of the MCA aneurysm.