• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.131-136
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• 2012

Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.75-78
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• 2015

High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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• pp.183-190
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• 1987

In Raynaud's phenomenon, the authors measured finger blood flow after ice water exposure by analyzing the time activity curve of radionuclide angiography on both hands. The results were as follows: 1) The digital blood flow did not decrease after ice water exposure in normal subjects. 2) In the patients with Raynaud's phenomenon, there were two groups: the one had decreased digital blood flow after cold exposure, and the other had paradoxically increased digital blood flow after cold exposure. 3) There was no difference in the digital blood flow of hand in room temperature between the normal and the patients with reduced digital blood flow after cold exposure, but the digital blood flow of the hand in room temperature was markedly reduced in the patients with paradoxically increased flow after cold exposure. 4) In the static image the difference was not significant in comparision with the dynamic study, because it represents pooling of the blood in the vein rather than flow. 5) After the treatment with nifedipine, the digital blood flow increased. In conclusion, the radionuclide angiography was useful in measuring the digital blood flow in Raynaud's phenomenon, and further studies with various drugs is expected.

• Journal of Korea Multimedia Society
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• v.11 no.4
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• pp.492-503
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• 2008

With the recent development and increasing importance of personal identification systems, biometric technologies with less risk of loss or unauthorized use are being popularized rapidly. In particular, because of their high identification rate and convenience, fingerprint identification systems are being used much more commonly than other biometric systems such as iris recognition, face recognition and vein pattern recognition. However, a fingerprint identification system has the problem that artificially forged finger-prints can be used as input data. Thus, in order to solve this problem, the present study proposed a method for detecting forged fingerprints by measuring the degree of attenuation when the light from an optical fingerprint sensor passes through the finger and analyzing changes in the transmission of light over stages at fixed intervals. In order to prove improvement in the performance of the proposed system, we conducted an experiment that compared the system with an existing multi-sensor recognition system that measures also the temperature of fingerprint. According to the results of the experiment, the proposed system improved the forged fingerprint detection rate by around 32.6% and this suggests the possibility of solving the security problem in fingerprint identification systems.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.38-42
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• 2011

Purpose: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. Materials and Methods: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. Results: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. Conclusions: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Journal of Oriental Neuropsychiatry
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• v.3 no.1
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• pp.46-55
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• 1992

This clinical study aims to find out the effect of the fingertip's temperature and beverage-taking on the personality test by MMPI (Minnesota Multiphasic Personality Inventory). This is based on the sample survey on the 5 groups ; two or more-veined-handed group (15 persons), one-veined-handed group (22 persons), non-veined-hanede group(13 persons), beverage-taking group (41 persons) and beverage-non-taking group (14 persons). The result was obtained as follows ; 1. In the comparative examination on the two or mire-veined-haned group and the non-veined-handed group, there was significant difference of the temperature between the scale D and the scales of Mf, Pa, Pt, and Sc. 2. For the scales of Hs, D, Hy and the scales of Pd, Pa, Pt, Sc, the one-veined-handed group showed higher T-scores and lower fingertip's temperature than the non-veined-handed group without singnificant difference between them. 3. For the scales of D, Hy and the scales of Pd, Pa, Pt, Sc, the beverage-taking group showed higher T-scores and lower fingertip's temperature than the beverage-non-taking group without significant difference between them. As a result, I could find that low temperature on the fingertip, protruded vein on three knuckles(三關) of the finger and beverage-taking would cause the blood-extravasation(血瘀) and the lack of the transports in the spleen(脾不運化) and have an influence on Neurosis and Psychosis.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.56-61
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• 2000

Recommendable reconstructive surgery in the patient with thumb amputation through base of the first metacarpal bone is pollicization. Some patients who do not agree with harvest sound finger as a new thumb, we can consider other options as toe transplantation or osteoplastic thumb reconstruction for creating thumb. Toe transplantation to the thumb is effective procedure in the amputation of distal to metacarpal shaft, it is rarely indicated in the cases of proximal to base of the first metacarpal bone. We performed three cases of modified osteoplastic thumb reconstruction with free vascularized rib that combined with scapular free flap or radial forearm flap. The length of transplanted rib ranged from 7~11cm, the donor vessels are posterior intercostal artery and vein which anastomosed to radial artery. The grafted rib wrapped with additional free flap for creating new thumb. Result of that procedure was not much encouraging, aesthetic appearance and mobility of thumb were not so satisfactory but reconstructed thumb gave improvement of the hand function without sacrificing toe or other digit. That gave reasonable stability for powerful side pinch and three pod pinch and opposable thumb with normal carpo-metacarpal joint motion that can give much function to the thumb absent hand. In spite of those disadvantages, thumb reconstruction with rib transfer can be useful for patients who do not want to lose another part of the body for creating thumb in basal amputation of the thumb metacarpal.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1751-1758
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• 2012

Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study compared the blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinical validity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger ($G_F$) and the forearm ($G_A$) with a portable glucometer under overnight fasting state. Then, the venous glucose concentration ($G_V$) was measured in 514 subjects in less than 1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. $G_A$ was highly correlated with $G_F$ or $G_V$ showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than ${\pm}10mg/dL$ regardless of the sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value in both groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regression analysis were < ${\pm}20%$ and < ${\pm}20mg/dL$, respectively, which were within the clinically acceptable ranges. These three statistical techniques introduced in the present study well demonstrated the consistency of $G_A$ with $G_F$ and $G_V$. Therefore, the forearm blood glucose test could be considered as clinically valid under fasting condition.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.143-148
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• 2001

The hand with amputation of all fingers is useless for activities of daily living and traumatic amputation of some of the fingers can result in the diminished ability to perform power grip and precision grip which is vital to maintain normal function of the hand. Precision grip is used to hold an object between the opposable thumb and flexed fingers. In power grip the object is held between the flexed fingers and the palm while the thumb applies the necessary counterpressure to maintain the grip on the object. A 35 year old male lost his right all fingers including thumb at the level of proximal phalanx from the pressure machinary accident. Thumb was reconstructed using wrap around flap and the second and third fingers were reconstructed using the second and third toe transplantation. Seven years after reconstruction, he uses the reconstructed thumb and the second and the third fingers for eating meals, writing down a paper with a pencil and putting on socks.