• Archives of Craniofacial Surgery
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• v.25 no.1
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• pp.17-21
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• 2024

Background: The pain caused by local anesthetic injection can lead to patient anxiety prior to surgery, potentially necessitating sedation or general anesthesia during the excision procedure. In this study, we aim to compare the pain relief efficacy and safety of using a digital automatic anesthetic injector for local anesthesia. Methods: Thirty-three patients undergoing excision of a benign soft tissue tumor under local anesthesia were prospectively enrolled from September 2021 to February 2022. A single-blind, randomized controlled study was conducted. Patients were divided into two groups by randomization: the experimental group with digital automatic anesthetic injector method (I-JECT group) and the control group with conventional injection method. Before surgery, the Amsterdam preoperative anxiety information scale was used to measure the patients' anxiety. After local anesthetic was administered, the Numeric Pain Rating Scale was used to measure the pain. The amount of anesthetic used was divided by the surface area of the lesion was recorded. Results: Seventeen were assigned to the conventional group and 16 to the I-JECT group. The mean Numeric Pain Rating Scale was 1.75 in the I-JECT group and 3.82 in conventional group. The injection pain was lower in the I-JECT group (p< 0.01). The mean Amsterdam preoperative anxiety information scale was 11.00 in the I-JECT group and 9.65 in conventional group. Patient's anxiety did not correlate to injection pain regardless of the method of injection (p= 0.47). The amount of local anesthetic used per 1 cm² of tumor surface area was 0.74 mL/cm² in the I-JECT group and 2.31 mL/cm² in the conventional group. The normalization amount of local anesthetic was less in the I-JECT group (p< 0.01). There was no difference in the incidence of complications. Conclusion: The use of a digital automatic anesthetic injector has shown to reduce pain and the amount of local anesthetics without complication.

• Journal of Biomedical Engineering Research
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• v.30 no.4
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• pp.333-340
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• 2009

MR compatible coaxial-slot antenna for microwave hyperthermia was developed while its structure and size of each part were determined by computer simulation using finite element method(FEM). Its local heating performance was evaluated using tissue-mimic phantom and swine muscles. 2% agarose gel mixed with 6mM/$\ell$ $MnCl_2$ as a biological tissue-mimic phantom was heated by the proposed antenna driven by a 2.45GHz microwave generator. The temperature changes of the phantom were monitored using multi-channel digital thermometer at the distance of 0mm, 5mm, 10mm and 20mm from the tip center of the antenna. Also muscle tissue of swine was heated for 2 and 5minutes with 50W and 30W of microwave generator powers, respectively, to evaluate the local heating performance of the antenna. MRI compatibility was also verified by acquiring MR images and MR temperature map. MR signals were acquired from the agarose gel phantom using $T2^*$ GRE sequence with 1.5T clinical MRI scanner(Signa Echospeed, GE, Milwaukee, WI, U.S.A.) at Pusan Paik Hospital and were transferred to PC in order to reconstruct MR images and temperature map using proton resonance frequency(PRF) method and laboratory-developed phase unwrapping algorithm. Authors found that it has no severe distortion due to the antenna inserted into the phantom. Finally, we can conclude that the suggested coaxial-slot antenna has an excellent local heating performance for both of tissue-mimic phantom and swine muscle, and it is compatible to 1.5T MRI scanner.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.411-419
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• 1993

A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.1
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• pp.45-54
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• 2019

Background: Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. Methods: Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. Results: The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. Conclusions: The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.71-79
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• 2013

Local pain management is the most critical aspect of patient care in dentistry. Local anesthesia is a reversible blockade of nerve conduction in an applied area that produces loss of sensation. The chemical agents used to produce local anesthesia stabilize neuronal membranes by inhibiting the ionic fluxes required for the propagation of neural impulses. Proper local anesthesia permits the dental surgeon to perform the necessary surgical procedure in a careful, gentle fashion that will be less stressful for both the operator and the patient. The improvements in agents for local anesthesia are probably the most significant advances that have occurred in dental science. Today's anesthetics are safe, effective, and can be administered with insignificant soft tissue damage and minimal concerns for allergic reactions. This article reviews the widely used local anesthetic agents for obtaining local anesthesia, and also discusses some frequently seen complications.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.89-97
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• 1997

Twenty hundred and five out of 266 patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Jan. 1994, were analyzed in the aspect of survival and local recurrence. Fifty one patients were excluded due to inadequate data and follow up. Prognostic factors for survival were evaluated statistically. One hundred and four cases were male, 101 female. Average age was 39.7(range 1 to 77) year with a peak incidence around 4th decade. The most frequent diagnosis was malignant fibrous histiocytoma(MFH)(24.1%). Liposarcoma, synovial sarcoma, rhabdomyosarcoma, malignant peripheral nerve sheath tumor and fibrosarcoma were relatively common diagnostic entities, in decreasing order. In location, extremity was 179(87.3%) and trunk 26(12.7%). Average follow up period was 7.5 years(6 months to 10 years). Actuarial 5 years and 10 years survival rate were 64.0% and 40.8% respectively. In univariate analysis with log-lank test, significant differences in survival rate were noted in histopathological diagnosis, size(10 cm), stage and metastasis. Age, sex, tumor location, tumor depth and local recurrence didn't affect the survival rate. Adjuvant chemotherapy and/or radiotherapy did not affect overall survival rate, but lowered the local recurrence rate when compared with surgery only. Surgical margin did not affect the survival rate, but local recurrence rate was different according to each margin; 5.7% in more than wide; 39.5% in marginal; and 60.0% in intralesional excision. In multivariate analysis for results of univariate analysis with Cox's propotional model, metastasis was a meaningful factor for survival of soft tissue sarcoma.

• The Journal of the Korean dental association
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• v.56 no.1
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• pp.58-65
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• 2018

Dental local anesthesia is important procedure for the elimination of pain during dental treatment. However, the pain during local anesthesia is one of the main source of fear to the patients. The cause of pain during dental local anesthesia includes soft tissue damage during penetration of the oral mucosa, pressure from the spread of the anesthetic solution, temperature of anesthetic solution, low pH of anesthetic solution, and the characteristics of the drug. Several concepts and devices introduced to date to reduce the pain during local anesthesia for dental treatment. In this report, devices that can reduce the pain during local anesthesia will be discussed.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.104-110
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• 2009

Purpose: Compared to soft tissue sarcoma, the relative risk of extraskeletal osteosarcoma is still not clear. The purpose of this study is to identify the difference in survival and local recurrence rate between two soft tissue sarcomas. Materials and Methods: Twelve patients with pathologically confirmed extraskeletal osteosarcoma were analysed. For retrospective matched case-control study, we selected 72 patients who were confirmed as high grade soft tissue sarcoma and had similar tumor location, tumor size and age to extraskeletal osteosarcoma. Results: Median age was 50 years old. Five cases were located in upper extremity, four in the buttocks, three in the lower extremity. Overall survival rate of extraskeletal osteosarcoma group and high grade soft tissue sarcoma group at 5 years were 52% and 55%. There is no significant difference (p=0.8). Local recurrence rate and metastasis rate were 58%, 67% in extraskeletal osteosarcoma group and 36%, 51% in soft tissue sarcoma group, which were not stastistically significant(p=0.2, p=0.4). Conclusion: Extraskeletal osteosarcoma have similar local recurrence, metastasis and survival rate compare to high grade soft tissue sarcoma. The number of patients of this study were too small to identify outcome of extraskeletal osteosarcoma. Further multi-institutional study should be attempted.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.37-43
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• 2000

Vascularized tissue coverage is necessary for treatment of soft tissue defect with bone and tendon exposure on hand and foot dorsum, which cannot be successfully covered with simple skin graft or local flap. The temporal fascia is one of the most ideal donor for coverage of soft tissue defect of dorsum of hand or foot in term of ultra-thin, pliable and highly vascular tissue. Also, this flap offers the advantage of a well-concealed donor site in the hair-bearing scalp and smooth tendon gliding. We have experienced 11 cases of reconstruction for soft tissue defect in the hand or foot using temporal fascial flap with skin graft. All cases survived completely and we could gain satisfactory functional results. There were no specific complications except one donor site alopecia We think that the free temporal fascial flap coverage is a highly reliable method for soft tissue defect in hand and foot dorsum. However, the potential pitfalls is secondary alopecia and requirement of skin graft after its transfer.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.753-758
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• 2007

Purpose: Penoscrotal extramammary Paget's disease is a rare cutaneous malignancy that primarily affects the elderly. To prevent local recurrence, adequate surgical excision with its intraoperative frozen section, proper reconstruction, and careful follow-ups are required. The present study describes the treatment of patients with penoscrotal extramammary Paget's disease, focusing on the reconstruction after the ablation of lesion. Methods: Nine patients were selected who had undergone a local pedicle flap procedure due to the large defects after ablation of extramammary Paget's disease of the penoscrotal area, during the period of 1999 to 2005. Wide excision combined with intraoperative frozen sectioning was performed, and the penoscrotal wound was reconstructed with a local skin flap. Three flaps were chosen depending on the size of the defect. If the defect size was small and the scrotal tissue was adequate, scrotal flap(n=5) was enough for its reconstruction. However, as there were large defects with insufficient remnant scrotal tissue, a groin flap(n=2) or an anterolateral thigh flap(n=2) were performed. Results: There were no complications with the postoperative wound. Furthermore, no local recurrence was noted during two to six years of follow-up period (mean average 3.7 years). Conclusion: For the resurfacing the penoscrotum at large defects after ablation of extramammary Paget's disease, we performed reconstruction with a local flap. In the aspect of both function and cosmetic concerns, the results were satisfactory.