• Archives of Plastic Surgery
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• v.35 no.4
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• pp.413-418
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• 2008

Purpose: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. Methods: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5 - 7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1 - 5), and degree of pain and patient satisfaction by visual analogue scale(0 - 10). Results: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were $3.29{\pm}0.529$(mean ${\pm}$ S.D.). Without the application, the mean score of epithelization were $2.86{\pm}0.655$(mean ${\pm}$ S.D.). The degree of pain was $7.71{\pm}1.419$(mean ${\pm}$ S.D.) and $2.35{\pm}0.950$(mean ${\pm}$ S.D.) before and after the application, respectively. The patients' satisfaction score was $6.45{\pm}0.850$(mean ${\pm}$ S.D.) and $8.45{\pm}0.961$(mean ${\pm}$ S.D.) before and after the application, respectively. Conclusion: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.163-166
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• 2011

Objective : Both the paraspinal muscle sparing approach and percutaneous screw fixation are less traumatic procedures in comparison with the conventional midline approach. These techniques have been used with the goal of reducing muscle injury. The purpose of this study was to evaluate and to compare the safety and efficacy of the paraspinal muscle sparing technique and percutaneous screw fixation for the treatment of L5-S1 spondylolisthesis. Methods : Twenty patients who had undergone posterior lumbar interbody fusion (PLIF) at the L5-S1 segment for spondylolisthesis were prospectively studied. They were divided into two groups by screw fixation technique (Group I : paraspinal muscle sparing approach and Group II: percutaneous screw fixation). Clinical outcomes were assessed by Low Back Outcome Score (LBOS) and Visual Analogue Scale (VAS) for back and leg pain at different times after surgery. In addition, modified MacNab's grading criteria were used to assess subjective patients' outcomes 6 months after surgery. Postoperative midline surgical scarring, intraoperative blood loss, mean operation time, and procedure-related complications were analyzed. Results : Excellent or good results were observed in all patients in both groups 6 months after surgery. Patients in both groups showed marked improvement in terms of LBOSs all over time intervals. Postoperative midline surgical scarring and intraoperative blood loss were lower in Group II compared to Group I although these differences were not statistically significant. Low back pain (LBP) and leg pain in both groups also showed significant improvement when compared to preoperative scores. However, at 7 days and 1 month after surgery, patients in Group II had significantly better LBP scores compared to Group I. Conclusion : In terms of LBP during the early postoperative period, patients who underwent percutaneous screw fixation showed better results compared to ones who underwent screw fixation via the paraspinal muscle sparing approach. Our results indicate that the percutaneous screw fixation procedure is the preferable minimally invasive technique for reducing LBP associated with L5-S1 spondylolisthesis.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.1-8
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• 2011

The objective of this study was to determine the effectiveness of topical 5% EMLA cream versus 20% Benzocaine gel in reducing pain from intra oral needle insertion alone as well as injection of anesthetic. The 2 topical anesthetics were tested against each other bilaterally using a randomized, controlled, single blinded, split mouth design. Phase I was conducted to find out the rapidity of onset action of the two agents on anterior/posterior vestibules and anterior/posterior palatal mucosa. Phase II was conducted to evaluate the efficacy of the two topical anaesthetic agents in reducing the pain of intraoral injections. The agents were left in anterior/posterior vestibules and anterior/posterior palatal mucosa for the amount of time recorded in phase I. Subjects recorded pain on a 100-mm modified visual analog scale(VAS). A pulse oximeter was used to recorded the preoperative and postoperative pulse rates. In phase I of the study, two topical agents showed the longer onset of action at anterior part and vestibules than posterior part and palatal mucosa. EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. In phase II of the study, the VAS grading of the pain for anesthetic administration showed EMLA cream was significantly(P<.05) better in elimination or reducing the pain on the anterior/posterior palatal mucosa. In conclusion, EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. EMLA cream was found to be superior to Benzocaine gel with regards to pain reduction for anesthetic administration especially on anterior and posterior palatal mucosa.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.4
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• pp.57-65
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• 2016

This study was conducted a visual landscape resources inventory and grade assessment on natural resources and cultural resources of Chiaksan National Park. Landscapes of National Parks are categorized into four types: seascape, mountain landscape, village landscape, and temple historical landscape. Landscape lists were constructed for each district for a total of 120 lists through field research on 7 trails. The landscape list per trail has Guryong~Birobong(31%), Seungnam~Namdaebong(22%), Geumdae~Namdaebong(16%), Bugok~Hanenggu(165), Hwanggol~Ipseoksa(6%), Hyangrobong~Nandaebong(5%) and Godeunjae~Wontonggol(4%). Landscape Assessment items were divided into five characteristics of view, unique, use, history culture, natural reflected by item. Items were divided into three grades of landscape by 4, 3, 2, 1 for each item of the assessment criteria and Delphi survey. Mountain landscapes were assessed in I grade of 72 sites, II grade of 26 sites, III grade of 7 sites. Temple Historical landscapes were assessed in I grade of 4 sites, II grade of 7 sites, III grade of 4 sites. The study results can be used as a basis for mountain parks management. It is necessary to focus on managing the landscape of I grade site. The higher ratings of the Mountain landscapes are related to the view and natural score. Also, the grading of Temple Historical landscapes is related to the history cultural, natural and use score. In addition, the mountain landscape were identified as being included outside landscape resources, the place of landscape resources with outside ratings were higher and the view was related. Landscape management is needed for the conservation of Mountain landscape and Temple Historical landscape type rating as excellent areas on the basis of the results of the inventory and assessment. For future improvement the Guryong-Birobong trail is judged as a harmonious representative landscape of the Mountain and Temple Historical landscape and will require conservation as a focus management area. In the case of Mountain landscape improvements, maintenance such as pruning trees, wood observatory and interpretation sign for a landscape with minimal inhibitory landscaping is needed. When installing artificial facilities in the Temple Historical landscapes, the use of materials harmonizing with the surroundings landscape must be considered as well as the standards of facilities limitation.

• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.484-492
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• 1999

Purpose: This study was to evaluate the clinical usefulness of $^{99m}Tc$-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. Materials and Methods: Twenty-four patients (M:F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq $^{99m}Tc$-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. Results: Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.16. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. Conclusion: $^{99m}Tc$-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for $^{99m}Tc$-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.484-492
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• 1996

To detect ischemic tissue in experimental model of cerebral ischemia made by middle cerebral artery(MCA)-occlusion, we acquired triple image of $^{99m}Tc$-glucarate, [$^{18}F$]fluoro-deoxyglucose (FDG), and 2,3,5- triphenyltetrazolium (TTC) staining. We made cerebral infarction either with reperfusion (after occlusion of 2 hours) or without reperfusion in 10 Sprague-Dawley rats by inserting thread to MCA through internal carotid artery. After 22 hours, we injected 740 MBq of $^{99m}Tc$-glucarate and 55.5 MBq of [$^{18}F$]FDG through tail vein. Each 1 mm slice of rat brains was frozen and exposed to imaging plate for 20 minutes in freezer to get an [$^{18}F$]FDG image. After 20 hours enough to fade radioactivity of [$^{18}F$]FDG, the slices were again imaged by BAS1500 for $^{99m}Tc$-glucarate uptake. Finally, these brain tissues were stained with TTC. Semi-quantitative visual analysis was done by grading 0 to 3 points according to the degree of uptakes($^{99m}Tc$-glucarate) and decreased uptakes([$^{18}F$]FDG and TTC). Ten rats survived with neurologic symptoms. TTC staining confirmed the development of infarction. The size of the infarction was relatively larger in the group without reperfusion. [$^{18}F$]FDG images were similar to TTC-stained images. However, we found regions with intermediate uptake which were not stained with TTC. We found regions with intermediate [$^{18}F$]FDG uptake where TTC staining was normal. $^{99m}Tc$-glucarate uptake was round only in TTC non-stained region. In the TTC stained regions, there were no uptake of $^{99m}Tc$-glucarate. We could not find clear relation between $^{99m}Tc$-glucarate uptake with [$^{18}F$]FDG uptake. This was partly because percent uptake of $^{99m}Tc$-glucarate was so small (less than 1 percent of injected dose) and because there were quite heterogeneity of patterns of [$^{18}F$]FDG uptake and TTC. With these findings, we could conclude that $^{99m}Tc$-glucarate were taken up only in part of ischemic tissues which were proven to be nonviable. The establishment of MCA-occluded rat model with or without reperfusion and triple imaging for $^{99m}Tc,\;^{18}F$ and TTC helped the characterization of $^{99m}Tc$-glucarate uptakes. Further work is needed to clarify the meaning or diversities or [$^{18}F$]FDG and TTC and their relation with $^{99m}Tc$-glucarate.