• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.28-34
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• 1998

The traditionally useful coverage methods of the wrist and hand soft tissue defect are the chinese forearm flap, the ulnar forearm flap. But, this flaps are inevitably sacrifice major vessel to the hand. Advantages of the posterior interosseous artery island flap(PIA Flap) is no need to sacrifice blood supply to the hand and supply relatively large thin, good quality flap and more cosmetic than other forearm flaps. But, it is difficult to dissect and raise because of deep seat, close relation with the posterior interosseous nerve and anatomic variation. Authors evaluated 8 cases of 7 patients in the department of orthopaedic surgery, college of medicine, Hallym University from January, 1993 to December, 1995. The results are as follows: 1. The satisfactory coverage was achieved 7 cases and 1 case failed because of anatomic variation. 2 The pedicle length is average 9cm and the flap size is variable from 3cm by 4cm to 5cm by 8cm. 3. The donor site defect was repaired by direct closure in 5 cases, remained 3 cases combined with skin graft. From our experience we conclude that the PIA flap is one of the useful coverage methods of the wrist and hand soft tissue defect.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.152-156
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• 2005

Purpose: We reconstructed the thumb with groin flap combined with secondary heterodigital neurovascular island flap and report our 6 cases. Materials and Methods: Between March 2003 and August 2004, 6 degloving thumbs or amputation of thumbs were reconstructed with groin flap combined with secondary heterodigital neurovascular island flap. There ware 4 men and 2 women, and mean age was 42.2 years. The following parameters were evaluated. Results: Recipient thumb was no limitation of apposition. but flexion contracture of interphalangeal joint was about 10 degree in two cases. Average grip power were 80% and average pinch power were 70% that of the normal thumb. The two point discrimination was average 10.5 mm and double sensibility in 2 cases. 2 patients have cold intolerance. Neuroma formation was not made. Cosmetic results as judged by patients were that 4 cases are good and 2 cases are fair. Conclusion: If massive skin defect after degloving thumb or amputation of thumb are present, we consider the numerous methods for reconstruction of thumb. This surgical procedure is good methods because of it's pliability, sensation, satisfactory functional results but major disadvantage are the staged operation and cosmetic effect of the absence of thumb nail.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.105-111
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• 2005

Perforator flaps have become increasingly popular in microsurgery nowadays and are being used widely for many cases of reconstruction after trauma and cancer ablation. And thoracodorsal perforator based free flap is one of them having the merits of carrying a large skin paddle with leaving intact innervation and function of the remaining latissimus dorsi muscle. We made a homogeneous thin flap excluding the main muscle with a long vascular pedicle and tried to decrease the donor site morbidity. But, it needs a long learning-curve and we have met marginal flap necrosis frequently. Besides, prolonged operation time for complete perforator dissection may be a tedious job to the microsurgeon. To overcome these disadvantages, we usually included very small portion of the latissimus dorsi muscle during this flap elevation around the pedicled 2-3 thoracodorsal perforators during this flap elevation. We performed 3 cases of thoracodorsal perforator based free flap at Hallym university sacred heart hospital between May and August 2005 for the soft tissue defect of the scalp and feet. The average flap size was $8{\times}14\;cm$. Although it is not a true perforator flap, we can get the reliability for the flap survival with much better blood circulation and save the time of one or two hours to dissect the perforators completely. All cutaneous flaps survived completely without any complication except one fatty female who had the very small superficial fat necrosis due to flap bulkiness. We believe the thoracodorsal perforator based free flap can be extended its versatility and reliability by including the very small portion of the muscle around the perforators.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.357-363
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• 2005

Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.276-279
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• 2009

Fibroma of tendon sheath is an uncommon benign soft tissue tumor with a predilection for the hand or upper extremities with extremely rare intra-articular involvement. It is mostly comprised of slow-growing fibrous lobules made up of scattered fibroblasts in a dense stroma with slit-like vascular channels. An unique case in a 54-year-old male patient involving the glenohumeral joint arising from postersuperior joint capsule is reported. Magnetic Resonance Imaging (MRI) reveals a focal nodular mass with decreased signal intensity on all pulse sequences and pathology confirmation was made with arthroscopic excision. Intra-articular fibroma of tendon sheath should be considered in the differential diagnosis of intra-articular soft tissue masses during shoulder arthroscopy.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1146-1151
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• 2023

Medullary thyroid carcinoma (MTC) is a rare malignancy that originates from the parafollicular cells of the thyroid gland. Hashimoto's thyroiditis (HT) is an autoimmune thyroid disease and is the most common cause of hypothyroidism. Previous studies have frequently discussed the association among HT, papillary thyroid carcinoma, and thyroid lymphoma. However, there have been few reports on the ultrasonographic findings of concomitant HT and MTC. In the present case, a heterogeneous hypoechoic background parenchymal echogenicity, with intraglandular echogenic strands, and increased vascularity were observed. A concurrent, ill-defined, parallel-oriented, heterogeneous hypoechoic mass with central microcalcifications was located at the left thyroid gland, consistent with reported US findings of medullary thyroid carcinoma except for an ill-defined margin in our case.

• Progress in Medical Physics
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• v.20 no.2
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• pp.80-87
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• 2009

Phase transformation, superelastic characteristics and variation of surface residual stress were studied for Nitinol shape memory alloy through application of UNSM technology, and life extension methods of stent were also studied by using elastic resilience and corrosion resistance. Nitinol wire of ${\phi}1.778$ mm showed similar surface roughness before and after UNSM treatment, but drawing traces and micro defects were all removed by UNSM treatment. It also changed the surface residual stress from tensile to compressive values, and XRD result showed less intensive austenite peak and clear martensite and additional R-phase peaks after UNSM treatment. Fatigue resistance could be greatly improved through removal of surface defects and rearrangement of surface residual stress from tensile to compressive state, and development of surface modification system to improve not only bio-compatability but also resistance to corrosion and wear will make it possible to develop vascular stent which can be used for circulating system diseases which run first cause of death of recent Koreans.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.62-68
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• 1994

This study was aimed to compare the density of the functional microcirculation of hepatocellular carcinoma (HCC) with normal liver and to investigate the effect of hepatic-arterial oily chemoembolization (HAE) by radionuclide examination. Methods : Eight patients with HCC proven by biopsy in five, and clinically and radiologically in three were included. The mixture of 2 cc normal saline with three to four mCi of $^{99m}Tc$-MAA was infused through a hepatic-arterial catheter for a minute. Dynamic images were obtained at a rate of 4 sec per frame for a minute, and static images and SPECT were followed. Results : In three patients who underwent hepatic arterial angiography (HAA) alone, radioactivity was markedly increased in tumors compared to the adjacent liver immediately after infusion of $^{99m}Tc$-MAA. The ratios of tumoral and extratumoral up-take (T/E ratio) were above 6.5 (range; $6.5{\sim}l9$, mean; 12.5). In four of the five patients who under-went superselective HAE, T/E ratio were remark-ably decreased ($0.5{\sim}1.3$). The areas of embolization were better delineated in radionuclide study than in postembolization HAA. In the other one who was considered to be embolized completely on HAA, strong radiouptake in the tumor was disclosed (T/E ratio; 7.0). Conclusions : Therefore hepatic-arterial flow study with radionuclide imaging using $^{99m}Tc$-MAA can be a valuable method to assess the accurate embolization effect in HCC.

• Applied Microscopy
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• v.39 no.1
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• pp.27-40
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• 2009

Acute respiratory distress syndrome (ARDS), also known as an acute inflammatory lung disease is developed by various factors that is originated from the destruction of alveolar-capillary barrier, and neutrophils plays an important role in the destruction. The study intended to confirm, the anti-inflammatory effect of germanium, whether a lung injury has been mitigated with the reduction of injury in alveolar-capillary barrier resulting from inhibition of neutrophils migration in lung tissue. Test groups were divided in saline administered CON, 5 hours of endotoxin administered LPS and 5 hours of endotoxin administered Ge+LPS following 1 hours of pre-processed germanium. $100{\mu}g$ endotoxin was melted in 0.5 mL saline and sprayed into airway and 26 mg germanium per 100 g weight was administered into abdominal cavity. The endotoxin group which induced an acute lung injury with administered endotoxin showed dramatic increase of pulmonary edema (p<0.001), protein contents in bronchoalveolar lavage fluid, BALF (p<0.05) and neutrophils of infiltration in BALF (p<0.001) comparing with a control group, while a pre-treated germanium group showed significant decrease in all categories comparing to the endotoxin administerd group. In the result of a microscopic observation, the structure of alveolar-capillary barrier which is constructed with basal lamina, alveolar type I cells and endothelial cell were preserved of the pre-treated germanium group relatively well compare to the endotoxin administered group. And the construction of lamellar body, microvilli and basal lamina of alveolar type II cells were also preserved relatively well. Hence, germanium activates as an anti-Inflammatory mediator in other words, it interfered neutrophils migration into lung tissue, thereby reduced injury of alveolar-capillary barrier from toxic substances of activated neutrophils. Consequently, the study has determined that the acute lung injury induced by endotoxin has been decreased by the pre-treated germanium.

• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.47-57
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• 1989

T. verrucosum infection has been reported for the first time in 1986 in Korea and has been increasing progressively. To evaluate the progress of clinical and histopathological change of dermatophytosis caused by T. verrucosum, inoculation study, using T. verrucosum isolated from infected human(human strain) and from infected cattle(cattle strain), was done in 24 male albino Hartley guinea pig. Their clinical and histopathological changes were evaluated. In addition, comparison for the growth rate between human strain and cattle strain on Sabouraud's glucose agar was made. The results were as follows: 1. Growth rate on Sabouraud's glucose agar : Cattle strain showed significantly more rapid growth rate than human strain on Sabouraud's glucose rate at $25^{\circ}C$ and $37^{\circ}C$. And cattle strain showed more rapid growth rate at $37^{\circ}C$ than $25^{\circ}C$. But human strain showed no significant difference of growth rate at both temperature. 2. Clinical findings: Initial erythema, scale and crust were developed about 8th after inoculation. All three findings reached maximum severity about 12th to 16th day and disappeared about 30th to 34th day after inoculation. There was no significant difference in progress of erythema, scale and crust between cattle strain and human strain. 3. Histopathological findings: Although mild acanthosis was noticed on the 3rd day after inoculation, the other findings including parakeratosis, intraepidermal abscess, spongiosis and vascular change, cellular infiltration were found on 9th day after inoculation. They reached maximum severity on the 12th day and lasted to the 25th day after inoculation. After that, all three findings were decreased gradually between 29th day and 33th day. On the PAS stainings, hyphae and spores were found on the 6th day and disappeared on the 21th day after inoculation. 4. In trichophytin skin test, all of the 24 guinea pigs became positive within average $9.83{\pm}1.17$ lays. These findings suggested that dermatophytosis caused by T. verrucosum induced rapid cell mediated immunity and contributed to rapid resolution of the lesion.