• Journal of The Korean Dental Society of Anesthesiology
• /
• v.9 no.2
• /
• pp.108-115
• /
• 2009

Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.4 no.1
• /
• pp.36-42
• /
• 2005

Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.12 no.1
• /
• pp.37-43
• /
• 2006

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The purpose of this study was to determine the biophysical effects of continuous ultrasound on median local forearm temperature and motor nerve conduction velocities using frequencies of 3.0 MHz. SUBJECTS: Twelve healthy subjects (6 males, 6 females, age $22.30{\pm}2.41$ yrs, weight $61.33{\pm}10.16$ kg, height $167.58{\pm}8.04$ cm) without a history of neurological or musculoskeletal injury to their dominant arm volunteered for this study. METHODS AND MATERIALS: Each subject received a total of five treatments, one each at .0, 0.5, 1.0, 1.5, 2.0 W/$cm^2$ of 3 MHz continuous ultrasound on the anterior surface of the middle area of dominant forearm for 10 minutes. Dependent measures for forearm local temperature and median motor nerve conduction velocity (MNCV) were taken pretreatment and immediately post-treatment. One-way ANOVA were used for each dependent measure. RESULTS: The posttreatment forearm local temperature were differed significantly (p<0.001) between intensities of ultrasound. The posttreatment forearm local temperature of the ultrasound treated with 1.0 w/$cm^2$, 1.5 w/$cm^2$ and 2.0 w/$cm^2$ were significantly higher than 0.5 w/$cm^2$ and 0.0 w/$cm^2$ of ultrasound (p<0.05). The posttreatment median MNCV were differed significantly from the respective pretreatment velocities (p<0.001). The MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were significantly (p<0.05) slower than that observed pretreatment, while the three ultrasound intensities produced significantly increased posttreatment MNCV: 1.0 w/$cm^2$ and 1.5 w/$cm^2$ and 2.0 W/$cm^2$. The posttreatment MNCV at 2.0 w/$cm^2$ and 1.5 w/$cm^2$ was significantly faster than that at 0 w/$cm^2$, 0.5 w/$cm^2$ and 1.0 w/$cm^2$ (p<0.05), the MNCV at 1.0 w/$cm^2$ was significantly faster than that associated with 0 w/$cm^2$ and 0.5 w/$cm^2$ of ultrasound (p<0.05). CONCLUSIONS: The decreased median motor forearm local temperature and MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were attributed to the cooling effect by ultrasound transmission gel. Local forearm temperature and nerve conduction velocity were directly related to the intensity of ultrasound. Alterations in MNCV from ultrasound on healthy nerves appeared to be related to temperature changes induced by thermal effects of ultrasound.

• Journal of Trauma and Injury
• /
• v.27 no.2
• /
• pp.20-24
• /
• 2014

Purpose: The temperature of a warm fluid infused into a patient is lowered because the line that allows the fluid to be infused into the patient is exposed to room air. This study evaluated the effects of aluminum foil used as an insulator surrounding the fluid infusion lines when using warm crystalloid fluids to treat traumatic shock patients. Methods: The study measured the differences in fluid temperature between infusion lines with and without the aluminum-foil insulation. We used 1L of normal saline at $40^{\circ}C$ as the infusion fluid, and the fluid infusion line was 200 cm long. The differences in temperature were measured for various fluid flow rates from 12,000 mL/min to 100 mL/min. We performed three experiments at each flow rate. Results: The results showed the differences in temperature between the groups with and without the aluminum insulation were significant for flow rates above 100 mL/min. Conclusion: Hypothermia in trauma patients results in many adverse complications such as peripheral vascular constriction, tissue hypoxia, metabolic acidosis, heart dysfunction and so on. Thus, the use of warm fluids and blood components is essential to reduce the probability of hypothermia. This study showed the aluminum foil wrapped around the infusion line had an insulator effect. As a result, such a wrapping can be used to avoid the adverse effects of hypothermia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.28 no.1
• /
• pp.53-60
• /
• 2002

Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

• Toxicological Research
• /
• v.26 no.4
• /
• pp.321-327
• /
• 2010

The ability of 80% ethanol extracts from five medicinal plants, Aralia continentalis, Paeonia suffruticosa, Magnolia denudata, Anemarrhena asphodeloides, and Schizonepeta tenuifolia, to neutralize hydroxyl radical, peroxyl radical and peroxynitrite was examined using the total oxyradical scavenging capacity (TOSC) assay. Peroxyl radical was generated from thermal homolysis of 2,2'-azobis(2-methylpropionamidine) dihydrochloride (ABAP); hydroxyl radical by an iron-ascorbate Fenton reaction; peroxynitrite by spontaneous decomposition of 3-morpholinosydnonimine N-ethylcarbamide (SIN-1). The oxidants generated react with $\alpha$-keto-$\gamma$-methiolbutyric acid (KMBA) to yield ethylene, and the TOSC of the substances tested is quantified from their ability to inhibit ethylene formation. Extracts from P. suffruticosa, M. denudata, and S. tenuifolia were determined to be potent peroxyl radical scavenging agents with a specific TOSC (sTOSC) being at least six-fold greater than that of glutathione (GSH). These three plants also showed sTOSCs toward peroxynitrite markedly greater than sTOSC of GSH, however, only P. suffruticosa revealed a significant hydroxyl radical scavenging capacity. Seven major active constituents isolated from P. suffruticosa, quercetin, (+)-catechin, methyl gallate, gallic acid, benzoic acid, benzoyl paeoniflorin and paeoniflorin, were determined for their antioxidant potential toward peroxynitrite, peroxyl and hydroxyl radicals. Quercetin, (+)-catechin, methyl gallate, and gallic acid exhibited sTOSCs 40~85 times greater than sTOSC of GSH. These four components also showed a peroxynitrite scavenging capacity higher than at least 10-fold of GSH. For antioxidant activity against hydroxyl radical, methyl gallate was greatest followed by gallic acid and quercetin. Further studies need to be conducted to substantiate the significance of scavenging a specific oxidant in the prevention of cellular injury and disease states caused by the reactive free radical species.

• Archives of Craniofacial Surgery
• /
• v.13 no.2
• /
• pp.125-129
• /
• 2012

Purpose: Methylmethacrylate is the most commonly used alloplastic material in cranioplasty. However during the polymerization of methylmethacrylate, a significant exothermic reaction takes place. This reaction may result in thermal injury to the brain tissue and other soft tissues. Also it is difficult to make three-dimensional methylmethacrylate implant that is perfectly matched to the defect during the operation time. We report on the molding technique of methylmethacrylate implant using plaster mold and the rapid prototyping model in cranioplasty. Methods: A 44-year-old male was referred to the department for severe frontal hollowness. He was involved in an automobile accident resulting in large frontal bone defect with irregular margin. The preformed patient-specific methylmethacrylate implant was made using plaster mold and the rapid prototyping model before the operative day. The methylmethacrylate implant was placed in the frontal defect and rigidly fixed with miniplates and screws on the operative day. Results: The operation was performed in an hour. In the 6 months follow-up period, there were no complications. Patient was satisfied with the results of cranioplasty. Conclusion: Safe cranioplasty was performed with the preformed patient-specific methylmethacrylate implant using plaster mold and the rapid prototyping model. The result of this method was satisfactory, aesthetically and functionally.

• Fire Science and Engineering
• /
• v.30 no.3
• /
• pp.16-22
• /
• 2016

Fire fighters rely on fire fighter protective clothing (FFPC) to provide adequate protection in the various hazardous environments. To enhance its protection performance, the FFPC material must be thick and thus it is difficult to achieve weight reduction. One of the methods of overcoming this problem, the addition of phase change material (PCM) to FFPC, is a new technology. In previous studies, the researches was mostly related to the temperature characteristics of the fibers incorporating PCM, but little information is available about its effect on burn injuries. Thus, in this study, the inhibitory effects of adding PCM to FFPC on second degree burns were investigated through numerical calculations. Thermal analyses of biological tissues and FFPC with embedded PCM exposed to several fire conditions causing severe tissue damage were studied by using a finite difference method based on the Pennes bio-heat equation. FFPC with embedded PCM was found to provide significantly greater protection than conventional fire fighting clothing, because the heat of absorption due to the phase change within the material is used to limit the heat conduction of the material.

• Clinics in Shoulder and Elbow
• /
• v.9 no.1
• /
• pp.105-110
• /
• 2006

Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.

• Korean Journal of Acupuncture
• /
• v.28 no.4
• /
• pp.17-28
• /
• 2011

Objectives : Burn is the important adverse effect of the moxibustion treatment. This research does with the purpose to utilize as basic data which the results of histological observation of the burn tissue which generates when operating various commercial indirect moxa (CIM) on the skin, evaluate the burn because of the surgical operation. Methods : It operated 6 kinds of CIM on the depilated abdomen of the rat. By using the H-E staining and TUNEL assay, the image was observed and analyzed. Results : It could be the moxibustion medical treatment using the CIM generated in the first degree burn until the third degree. And in some case, burn has not generated. By using the H-E stain, the second-degree burn and third degree was observed, and it was observed the first degree burn by using TUNEL assay. In the first degree burn, TUNEL reaction in the epidermal layer was confirmed. The damage to the dermal layer was observed in more than 2 degree burn. In the third degree, the tissue degeneration to the subcutaneous fat was observed but the thickness of the skin tissue was not observed. Conclusions : Basic data classifying the burn generated by the CIM treatment through the histological observation of the burn tissue caused by the CIM treatment were built according to this research result.