• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.668-674
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• 2000

Objective : The classic and accepted surgical method of compound comminuted depressed skull fractures (FCCD) involves total resection of all the contaminated bone and fragments at the fracture site. A second operation for cranioplasty is then performed at a later date. However, we have believed that primary repair of these bony defects can be achieved by the replacement of bone fragments at the time of the initial debridement, and this can be accomplished without danger to patient. The authors retrospectively reviewed the surgical results to assess the advantages and disadvantages, and also propose the selection criteria of replacement of fractured bone fragments as a primary procedure in FCCD. Materials and Methods : The authors analyzed the data extracted from medical records, and radiological findings in 22 of 71 patients with FCCD, who underwent immediate replacement of fractured bone fragments between April 1993 and October 1998. The mean follow-up period was 13.7 months. The selection criteria for the operation included the patients with mild to moderate severity, regardless of the degree of contamination or dural violation, which presented in hospital within 24 hours of injury. Results : The ages of the patients varied from 4 to 63 years, and there were 20 males and 2 females. Seventeen of 22 patients were fully conscious on admission and the others also had relatively good Glasgow coma scales. Sixteen fractures were located in the frontal area, 9 with involvement of the frontal sinuses, and 6 in the parietal and temporoparietal areas. Of the 22 patients, 8(36.3%) had dural lacerations with 3 of these requiring patching with pericranium, and 12(54.5%) had intracranial hematoma requiring wide craniotomy. The degree of wound contamination was also variable. Fifteen patients had relatively clean wounds, while seven(31.8%) had seriously contaminated wounds with soil, sand, hair, and wood. Only one patient(4.5%) developed infection, and the bone fragments were removed. All wounds healed primarily without pulsatile defect, the skull has remained solid, and no complications have occurred, except the infected case. Conclusion : It is proposed that bone fragments removal for FCCD, regardless of the degree of contamination or dural violation, is not necessary and that primary bone fragments replacement avoids a second operation for cranioplasty.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.399-403
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• 2010

Background: Video-Assisted Thoracic Surgery can be performed with the lung collapsed. During the procedure, pleural adhesion may result in lung injury, bleeding, and thoracotomy conversion. Identifying the presence of pleural adhesion before surgery can make it easy to plan trocar introduction and perform the procedure. Material and Method: Between June 2009 and November 2009, we performed ultrasound in 24 patients to detect pleural adhesion before surgery and compared the results with the operative findings. We primarily examined the lateral chest, where the trocar would be inserted, and, occasionally, the anterior or posterior chest. Result: Patient diseases were: 6 hyperhidroses, 8 interstitial lung diseases, 5 lung cancers, 2 mediastinal tumors, 1 peripheral pulmonary embolism, 1 metastatic lung cancer, and 1 sarcoidosis. Of the 22 patients who did not have pleural adhesions on ultrasound, four revealed mild adhesions not related to the trocar insertion sites. However, ultrasound showed pleural adhesions in two patients, consistent with the operative findings. There was no air leak or thoracotomy conversion related with trocar insertion. Conclusion: Ultrasound requires only a few minutes to detect the presence of the pleural adhesion and was very useful in identifying the pleural adhesion before VATS.

• Proceedings of the Korean Environmental Health Society Conference
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• 2003.06a
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• pp.157-157
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• 2003

To evaluate an effect of pathological liver damage on the cyclohexane metabolism, rats were pretreated with 50% $CCl_4$ dissolved in olive oil (0.1$\mell$/100g body weight) 10 or 17 times intraperitoneally at intervals of every other day. On the basis of liver function and histological findings, the animals pretreated with $CCl_4$ 10 times were identified as acutely liver damaged ones and the animals pretreated with $CCl_4$ 17 times were identified as severly liver damaged ones, with fibrosis, biliary abnormality and mild injury both in the kidneys and the lungs. To these liver damaged animals, cyclohexane (a single dose of 1.56g/kg body weight, i.p.) was administrated at 48 hours after the last injection of $CCl_4$. The rats were sacrificed at 4 or 8 hours after injection of cyclohexane. The cyclohexane metabolites; cyclohexanol (CH-ol), cyclohexane-1, 2-diol (CH-1, 2-diol), cyclohexane-l, 4-diol (CH-1, 4-diol), and their glucuronyl conjugates and cyclohexanone (CH-one) were detected in the urine of cyclohexane treated rats. After cyclohexane treatment, the serum levels of CH-ol and CH-one were remarkably increased at 4 hours and then decreased at 8 hours in normal group. Whereas in liver damaged rats, these cyclohexane metabolites were higher at 8 hours than at 4 hours. The excretion rate of cyclohexane metabolites from serum into urine was more decreased in liver damaged animals than normal group, with the levels of excretion rate being lower in $CCl_4$ 17 times injected animals than 10 times injected ones. However, it was interesting that the urinary concentration of cyclohexane metabolites was generally more increased in liver damaged animals than normal ones, and the increasing rate was higher in $CCl_4$ 17 times injected rats than 10 times injected ones. And liver damaged rats, especially $CCl_4$ 17 times treated ones, had an enhanced ability of glucuronyl conjugation to cyclohexanol analogues compared with normal group. Futhermore, CH-1, 2 and 1, 4-diol were all conjugated with glucuronic acid in $CCl_4$ 17 times injected animals. In conclusion, the metabolic rate of cyclohexane was unexpectably accelerated and it may be caused by physiological adaptation of adjacent intact hepatocyte in damaged liver.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.690-695
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• 2005

Nitric acid is an oxidizing agent used in metal refining and cleaning, electroplating, and other industrial applications. Its accidental spillage generates oxides of nitrogen, including nitric oxide (NO) and nitrogen dioxide ($NO_2$), which cause chemical pneumonitis when inhaled. The clinical presentation of a nitric acid inhalation injury depends on the duration and intensity of exposure. In mild cases, there may be no symptoms during the first few hours after exposure, or the typical symptoms of pulmonary edema can appear within 3-24 hours. However, in cases of prolonged exposure, progressive pulmonary edema develops instantaneously and patients may not survive for more than 24 hours. We report a case of a 44-year-old male who was presented with acute respiratory distress syndrome after nitric acid inhalation. He complained of cough and dyspnea of a sudden onset after inhaling nitric acid fumes at his workplace over a four-hour period. He required endotracheal intubation and mechanical ventilation due to fulminant respiratory failure. He was managed successfully with mechanical ventilation using positive end expiratory pressure and systemic corticosteroids, and recovered fully without any deterioration in his pulmonary function.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.41-45
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• 2008

Purpose: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. Materials and Methods: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. Results: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. Conclusion: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.

• Applied Microscopy
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• v.39 no.3
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• pp.261-266
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• 2009

This study aim to disclose a possible mechanism for the neuronal cell death induced by peripheral nerve injury following a spinal nerve ligation (SNL) as a neuropathic pain model. Male Sprague-Dawley rats (270~290 g) were used for this study. Pain threshold was evaluated for their response to mechanical (von Frey hairs) stimuli 1, 3, and 7 days after a tight ligation of L5 ventral ramus. In control group, the small ganglion cells were strongly stained with routine toluidine blue (TB), whereas the large ganglion cells showed a little bit weak stainity. Each large ganglion cell is surrounded by perineuronal satellite cells. In experimental groups, small ganglion cells showing apparent degenerative changes increased on 1 day, and showed a peak in degenerative cell number at 3 days group, and decreased gradually at 7 days group. We also found a small number of large-sized ganglion cells showing mild degenerative changes. However their satellite cells ware relatively intact with no typical findings throughout this experiment. Under the electron microscope, small ganglion cells showed various stage and typical features of the dark degeneration including mitochondrial swelling.

• Radiation Oncology Journal
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• v.4 no.2
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• pp.99-105
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• 1986

Optimal balance between control probability and risk of complication is emphasized even in present time, Although certain incidence of intestinal injury is accepted as an inevitable consequence after abdominopelvic irradiation, these complications still remain as problems. 60 mice were irradiated with 250 kVp orthovoltage x-ray machine and $200rad{\times}5/wk$ regimen. Histpathologic findings of colorectum and the relationship with occult blood test were analyzed and possible tolerable dose which would be safe from permanent complication was also estimated. Followings are the results: Mild mucosal and submucosal edema were observed in 1,000 rad irradiated group. Congestion of small vessels was prominent in 2,000 rad irradiated group and infiltration of inflammatory cells was observed in 3,000 rad irradiated group. Denuded mucosa was observed in 3,000 rad irradiated group. Occult blood test is not a proper indicator for rectal denuding or rectal ulcer, but our results suggest the possibility of using this as a relative scale of intestinal damage. Mitotic figures of crypt cells were observed even in 5,000 rad irradiated group, these suggest that the repair capacity of crypt cells are still functioning.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.916-922
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• 1996

In patients with pleural adhesion, video-assisted thoracic surgery (VATS) has been regarded as a contra- indication. When such adhesions were found during a thoracoscopic trial, the thoracotomy proceeded with for fear of parenchymal Injury and bleeding. We had a question whether or not thoracoscopic surgery should be done in such pleural adhesions. Of the 226 consecutive thoracoscopic surgeries from Jul. 1992 through Sep. 1995, pleural adhesions were detected intraoperatively in 50 cases (22.1%): a detailed breakdown is as follows: pneumothorax (16 cases), pleural disease (15), benign pulmonary nodule(7), mediastinal mass(5), hyperhidrosis (2), diffuse parenchymal or interstitial lung disease (2), bronchiectasis(2), and primary lung cancer(1). We classified pleural adhesions according to their extent and severity. Extent is categorized as the involved area of the lung: degree 1, II, or III; severity is given one of four grades: mild, moderate, severe, or ve y severe. In cases of very severe severity requiring decortication, the possibility of VATS was excluded. Of the 50 cases, mild adhesions were detected in 15 cases(30.0%), moderate in 29 (58.0%), and severe in 6 (12.0%). As for the extent of the adhesions, 8 cases (16.0%) were categorized as degree 1, 32 cases (64. 0%) as degree II, and 10 cases (20.0%) as degree III. For patients with pleural adhesions, the operation time, the chest tube indwelling time, and the postoperative hospital stay were all longer than for patients in the non-adhesion group. Postoperative complications, namely prolonged air-leakage and pleural drain- age, were more common (18.0% and 6.0%, respectively) than in the non-adhesion group (5.1% and 1.7%, respectively). Only two bronchiectatic patients (4%) were converted to an open thoracotomy because of in- ability to control bleeding. Although complications were encountered more frequently in the group with adhesions, patients were still able to enjoy the benefi s of thoracoscopic surgery. It is advisable to proceed with thoracoscopic surgery even in cases of unpredicted pleural adhesions.

• Journal of Nutrition and Health
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• v.41 no.5
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• pp.391-401
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• 2008

Probiotics have emerged as a potential treatment modality for numerous gastrointestinal disorders, including IBD. However, few probiotics have undergone appropriate preclinical screening in vivo. Kefir is considered a probiotic, benefiting the host through its effects in the intestinal tract. Despite numerous studies examining the action of probiotics on the host organism, few have analyzed the effects on intestinal environment. We assessed the protective effect of kefir for three weeks before inducing colitis with 2% dextran sodium sulfate for five days. The DSS loads were similar in all DSS treatment group. The results of the experiment are as follows. Food intake and FER of experimental groups were not significantly different each other, but water consumption tended to be higher in all DSS treatment groups as compared with the normal control. And visual inspection of feces revealed mild diarrhea in rat given 2% DSS. The anti-inflammatory activity of kefir was determined by myeloperoxidase activity during the DSS treatment, and there was no significant difference in any group. The levels of thiobarbituric acid reactive substances (TBARS) as a colonic lipid peroxidation were significantly lower in the kefir intake groups than in rats treated with 2% DSS alone. The DNA % in tail and tail moment values as a DNA damage level of the blood lymphocytes in kefir intake groups tended to be lower than 2% DSS treatment alone, especially tail lengths were significantly diminished. According to the colonic histopathological assay, there were a severe inflammation of lamina propria and submucosa and mild edema in mucosa and sub mucosa in DSS alone treated group. We found a slight regenerative change in kefir treatment groups. In our experiments, this means that ulcerative colitis related to oxidative injury might be prevented by kefir as a probiotic. Further studies of the potential benefits of kefir as a probiotic in inflammatory condition are encouraged.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.14-20
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• 2009

Background: The pathophysiologic mechanisms of radiation-induced lung injury should be elucidated to enhance the therapeutic efficacy of radiotherapy and to manage patients exposed to serious radiation by accident. It has been suggested that pro-inflammatory cytokines play an important role in radiation-induced effect on the lung. This study was aimed to investigate changes in pro-inflammatory cytokines such as TNF-$\alpha$, MIP-2, IL-1$\beta$ and HMGB1, a newly recognized inflammatory mediator. Methods: The chests of BALB/c mice were selectively irradiated with single fraction of 20 Gy and then sacrificed at indicated times. Pathologic changes in the lung were examined after H&E staining. The expression level of pro-inflammatory cytokines was evaluated by ELISA kits in lung homogenate and in serum. Results: Radiation induced inflammatory changes and mild fibrosis in lung. Biphasic increase of TNF-$\alpha$ and IL-1$\beta$ was found in lung homogenate at 4 hours and at 3 weeks after radiation. The elevation in the second phase tended to be more intense. However, there was no similar change in serum. MIP-2 level was slightly increased in lung homogenate at 4 hours, but not at 3 weeks. HMGB1 was increased at 3 weeks in serum while there was no significant change in lung homogenate. Conclusion: Radiation induced a biphasic increase in TNF-$\alpha$ and IL-1$\beta$. The effective control of second phase cytokine elevation should contribute to preventing severe lung fibrosis caused by radiation.