• Title/Summary/Keyword: Local tissue

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Microsurgical reconstruction of posttraumatic large soft tissue defects on face (광범위한 안면외상 환자에서의 미세술기를 이용한 재건술)

  • Baek, Wooyeol;Song, Seung Yong;Roh, Tai Suk;Lee, Won Jai
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.724-731
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    • 2018
  • Our faces can express a remarkable range of subtle emotions and silent messages. Because the face is so essential for complex social interactions that are part of our everyday lives, aesthetic repair and restoration of function are an important tasks that we must not take lightly. Soft-tissue defects occur in trauma patients and require thorough evaluation, planning, and surgical treatment to achieve optimal functional and aesthetic outcomes, while minimizing the risk of complications. Recognizing the full nature of the injury and developing a logical treatment plan help determine whether there will be future aesthetic or functional deformities. Proper classification of the wound enables appropriate treatment, and helps predict the postoperative appearance and function. Comprehensive care of trauma patients requires a diverse breadth of skills, beginning with an initial evaluation, followed by resuscitation. Traditionally, facial defects have been managed with closure or grafting, and prosthetic obturators. Sometimes, however, large defects cannot be closed using simple methods. Such cases, which involve exposure of critical structures, bone, joint spaces, and neurovascular structures, requires more complex treatment. We reviewed and classified causes of significant trauma resulting in facial injuries that were reconstructed by microsurgical techniques without simple sutures or coverage with partial flaps. A local flap is a good choice for reconstruction, but large defects are hard to cover with a local flap alone. Early microsurgical reconstruction of a large facial defect is an excellent choice for aesthetic and functional outcomes.

Efficacy of Alismatis Orientale Rhizoma on Obesity induced by High Fat Diet (고지방식이로 유발된 비만에 대한 택사의 항비만 효과)

  • Jeong, Hyang Sook
    • The Korea Journal of Herbology
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    • v.28 no.3
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    • pp.95-106
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    • 2013
  • Objectives : The researcher investigated the anti-obesity effect of Alismatis Orientale Rhizoma(AP) water extract in mice fed a high fat diet and focused on the analysis of local area adipose tissue. Methods : Male ICR mice were divided into three groups, which were fed either a normal AIN diet, a 45% high fat diet (CT group), or a high fat diet and orally administration with a concentrations of 100 mg/kg (AP100 group) and 300 mg/kg body weight (AP300 group) for eight weeks. Results : As compared with CT group, AP100 group showed significant reductions in absolute weight of liver. As compared with CT group, AP100 group and AP300 group showed significant reductions in weight gain and relative weight of total fat. AST, triglyceride, total-cholesterol levels from the AP 100 group and 300 group were significantly lower than those of the CT, and ALT, LDL-cholesterol levels from the AP 100 group was significantly lower than those of the CT. But serum HDL-cholesterol levels from the AP 100 group and 300 group were significantly higher than those of the CT. And serum adiponectin levels from the AP 100 group was significantly higher than those of the CT. In result of real time PCR, all mRNA expression(PEPCK, G6Pase, PGC-$1{\alpha}$ and $ERR{\gamma}$) of two experimental groups were significantly decreased compared to those of CT group. The treatment with AP on local abdominal area made a fat cell size lessen on the fat tissue in the abdominal cavity and subcutaneous area. Conclusions : These results suggest that AP has an anti-obesity effect and the effect is mediated by inhibition of fat gain.

Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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Tissue Fluid Enzyme-Linked Immunosorbant Assay for Piglets Experimentally Infected with Toxoplasma gondii and Survey on Local and Imported Pork in Korean Retail Meat Markets

  • Yoo, Won Gi;Kim, Sun-Min;Won, Eun Jeong;Lee, Ji-Yun;Dai, Fuhong;Woo, Ho Choon;Nam, Ho-Woo;Kim, Tae Im;Han, Jeong-Hee;Kwak, Dongmi;Cho, Yun Sang;Kang, Seung-Won;Kim, Tong-Soo;Zhu, Xing-Quan;Wang, Chunren;Youn, Heejeong;Hong, Sung-Jong
    • Parasites, Hosts and Diseases
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    • v.56 no.5
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    • pp.437-446
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    • 2018
  • To investigate the prevalence of Toxoplasma gondii in pork on the market in Korea, an in-house enzyme-linked immunosorbent assay for tissue fluid (CAU-tf-ELISA) was developed using a soluble extract of T. gondii RH strain tachyzoites. As the standard positive controls, the piglets were experimentally infected with T. gondii: Group A (1,000 cysts-containing bradyzoites), Group B (500 cysts-containing bradyzoites) and Group C ($1.0{\times}10^3$ or $1.0{\times}10^4$ tachyzoites). The CAU-tf-ELISA demonstrated infection intensity-dependent positivity toward tissue fluids with average cut-off value 0.15: 100% for Group A, 93.8% for Group B and 40.6% for Group C. When tissue-specific cut-off values 0.066-0.199 were applied, CAU-tf-ELISA showed 96.7% sensitivity, 100% specificity, 100% positive and 90.0% negative predictive values. When compared with the same tissue fluids, performance of CAU-tf-ELISA was better than that of a commercial ELISA kit. Of the 583 Korea domestic pork samples tested, anti-T. gondii antibodies were detected from 9.1% of whole samples and 37.9% from skirt meat highest among pork parts. In the 386 imported frozen pork samples, 1.8% (skirt meat and shoulder blade) were positive for anti-T. gondii antibodies. In Korea, prevalence of anti-T. gondii antibodies in the pork on retail markets appeared high, suggesting that regulations on pig farming and facilities are necessary to supply safe pork on the tables.

The Cross-Leg Gastrocnemius Muscle Flap for Leg Reconstruction of the Difficult and Unfavorable Conditions (비복근을 이용한 교차하지 근육 피판술)

  • Kim, Ji Ye;Yang, Eun Jung;Hwang, Eun A;Kim, Sug Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.583-590
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    • 2009
  • Purpose: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross - leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross - leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross - leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. Methods: Twelve patients(9 males and 3 females) underwent the operation between October of 2001 and December of 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross - leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days (3 to 6 weeks). Mean follow - up period was 4 years. Results: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional and cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches 3 months postoperatively. Conclusion: Although pedicled cross - leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.

Hierarchical Non-Rigid Registration by Bodily Tissue-based Segmentation : Application to the Visible Human Cross-sectional Color Images and CT Legs Images (조직 기반 계층적 non-rigid 정합: Visible Human 컬러 단면 영상과 CT 다리 영상에 적용)

  • Kim, Gye-Hyun;Lee, Ho;Kim, Dong-Sung;Kang, Heung-Sik
    • Journal of Biomedical Engineering Research
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    • v.24 no.4
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    • pp.259-266
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    • 2003
  • Non-rigid registration between different modality images with shape deformation can be used to diagnosis and study for inter-patient image registration, longitudinal intra-patient registration, and registration between a patient image and an atlas image. This paper proposes a hierarchical registration method using bodily tissue based segmentation for registration between color images and CT images of the Visible Human leg areas. The cross-sectional color images and the axial CT images are segmented into three distinctive bodily tissue regions, respectively: fat, muscle, and bone. Each region is separately registered hierarchically. Bounding boxes containing bodily tissue regions in different modalities are initially registered. Then, boundaries of the regions are globally registered within range of searching space. Local boundary segments of the regions are further registered for non-rigid registration of the sampled boundary points. Non-rigid registration parameters for the un-sampled points are interpolated linearly. Such hierarchical approach enables the method to register images efficiently. Moreover, registration of visibly distinct bodily tissue regions provides accurate and robust result in region boundaries and inside the regions.

Influence of Genotype and Ecotype on Anther Culture Efficiency in Hot Pepper (Capsicum annuum L.) (고추의 유전자형 및 생태형이 약배양 효율에 미치는 영향)

  • 김용권;권오열;윤화모
    • Korean Journal of Plant Tissue Culture
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    • v.26 no.1
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    • pp.49-52
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    • 1999
  • The influence of genotype and ecotype on the anther culture efficiency using hybrid of hot pepper (Capsicum annuum L.) was investigated. Anther culture efficiency was differently dependent on the genotype of parents. In the efficiency of embryo production, the cross combination using female parents with high embryo inducing ability was higher than those with low embryo inducing ability. It was shown that genotype and cytoplasm has effect on embryo production. Also the embryogenic ability was different according to ecotype of cross lines. The frequency of embryo production were the highest in Local variety $\times$ pimento cross combinations with 17.8~46.1 and the lowest in Pimento $\times$ Local variety cross combinations with 5.4~8.5%. Embryo inducing frequency was the middle value with 10.25~23.1% in Local variety $\times$ Tropical variety, Tropical variety $\times$ Local variety, Tropical variety $\times$ Pimento, and Pimento $\times$ Tropical variety cross combinations.

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Facial Nerve Paralysis Following Inferior Alveolar Nerve Block Anesthesia -A Case Report- (하지조신경 전달마취 후 발생한 안면신경마비)

  • Kim, Su-Gwan;Lee, Sang-Ho;Kim, Sik;Kim, Hyun-Ho;Yoon, Gwang-Cheol;Choi, Hee-Yeon;Park, Oh-Joo;Choi, Young-Ock;Kim, Sang-Ho
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.4 no.1 s.6
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    • pp.21-24
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    • 2004
  • Facial nerve paralysis following the administration of a local anaesthetic can be alarming. By reading reports of such incidents, dentists who find themselves in similar situations will be able to reassure their patients and act accordingly. This article reviews the classifications of anesthetic complication, local complications, etiology, prevention, treatment of facial nerve paralysis fellowing the administration of a local anaesthetic. A thorough knowledge of the relevant anatomy pertinent to the various injections used in dental surgery is essential.

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The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery

  • Ping, Bushara;Kiattavorncharoen, Sirichai;Saengsirinavin, Chavengkiat;Im, Puthavy;Durward, Callum;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.2
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    • pp.69-76
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    • 2015
  • Background: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. Methods: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. Results: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. Conclusions: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

Comparison of clinical efficacy of ropivacaine and lignocaine with adrenaline for implant surgery anesthesia: a split-mouth randomized controlled clinical trial

  • Kalath, Remya Nath;Kulal, Rithesh;Gopinath, Sharika
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.4
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    • pp.337-344
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    • 2021
  • Background: The primary indication for using long-acting anesthetics in dentistry is extensive dental procedures that require pulpal anesthesia beyond 90 min and management of postoperative pain. Ropivacaine is an amide local anesthetic that is available at various concentrations with inherent vasoconstrictive properties at low concentrations. Ropivacaine has a 75% greater margin of safety than bupivacaine. Ropivacaine can be a good alternative to bupivacaine as a local anesthetic in dental implant surgery as it provides a longer duration of both pulpal and soft tissue anesthesia after mandibular nerve block and lowers CNS and cardiovascular toxicity. This study aimed to evaluate and compare the clinical efficacy of ropivacaine and lignocaine for implant surgery anesthesia. Methods: Fifteen patients with bilateral edentulous sites indicated for implant placement were recruited for this study. Patients aged 20-60 years of both sexes were randomly recruited. Thirty implant placements were performed in the test and control groups using ropivacaine and lignocaine with adrenaline as local anesthetics, respectively. Results: The results were analyzed statistically. The duration of anesthesia was significantly higher in the test group than in the control group. Ropivacaine was found to be superior to lignocaine in terms of the quality of anesthesia. The comparison of mean visual analog scale scores showed ropivacaine to have better anesthetic and analgesic effects than the control group. Conclusion: Ropivacaine 0.75% provides a significantly longer duration of anesthesia than lignocaine 2% with adrenaline. Ropivacaine 0.75% decreased intraoperative and postoperative analgesia compared to lignocaine 2% with adrenaline. Hence, ropivacaine 0.75% can be used as an alternative to lignocaine in implant surgeries and other intraoral surgical procedures that require a longer duration of anesthesia and analgesia.