• Archives of Plastic Surgery
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• v.36 no.3
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• pp.269-276
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• 2009

Purpose: Local skin necrosis after extravasation of adriamycin, a widely used chemotherapeutic agent, is a common problem in cancer patients. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. Thus the aim of this study was to compare the efficacy of saline injection(Group 1), hydrocortisone injection(Group 2), propranolol injection(Group 3) and early surgical excision as a treatment(Group 4) in a rat extravasation model. Methods: The authors planned forty mature male Sprague - Dawley rats were divided into 4 groups and each group contained 10 rats. Administration of adriamycin($1.0mg/m{\ell}$) $1.5m{\ell}$ by subcutaneous injection on the dorsal side of the rats was followed by protocol. The treatment options were applied 2 hours after adriamycin injection. At the end of the 5th days, the presence and size of ulcers at the injection site were measured. 3 weeks after injection, a histopathologic examination was performed for each treatment and control group. T - tests were used to analyze the differences between the measurements. Results: Propranolol significantly improved tissue recovery compared with control group and other groups. These data suggest that there is little role for saline and hydrocortisone in the treatment of adriamycin extravasation injury. Conclusion: In this study, we compared some treatment methods in adriamycin extravasation model. The findings support the propranolol injection may prevent extravasation injury. However this study was performed in the laboratory using rats, and the results could be different in clinical application. Thus, more needs further investigations and clinical application.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.2
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• pp.79-85
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• 2018

Objectives: The aim of this study was to evaluate the effects of herbal extracts on bone regeneration. Two known samples were screened. Materials and Methods: We previously established a rat calvaria defect model using a combination of collagen scaffold and herbal extracts. An 8 mm diameter trephine bur with a low-speed dental hand piece was used to create a circular calvaria defect. The experimental group was divided into 4 classifications: control, collagen matrix, Danshen with collagen, and Ge Gan with collagen. Animals in each group were sacrificed at 4, 6, 8, and 10 weeks after surgery, and bone regeneration ability was evaluated by histological examination. Results: Results revealed that both Danshen and Ge Gan extracts increased bone formation activity when used with collagen matrix. All groups showed almost the same histological findings until 6 weeks. However, after 6 weeks, bone formation activity proceeded differently in each group. In the experimental groups, new bone formation activity was found continuously up to 10 weeks. In the Danshen and Ge Gan groups, grafted materials were still present until 10 weeks after treatment, as evidenced by foreign body reactions showing multinucleated giant cells in chronic inflammatory vascular connective tissue. Conclusion: Histological analyses showed that Danshen and Ge Gan extractions increased bone formation activity when used in conjunction with collagen matrix.

• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.89-98
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• 2011

Background: Although considerable efforts have been made to improve the graft patency in coronary artery bypass surgery, the role of biomechanical factors remains underrecognized. The aim of this study is to investigate the influences of geometric configurations of the bypass graft on hemodynamic characteristics in relation to anastomosis. Materials and Methods: The Numerical analysis focuses on understanding the flow patterns for different values of inlet and distal diameters and graft angles. The Blood flow field is treated as a two-dimensional incompressible laminar flow. A finite volume method is adopted for discretization of the governing equations. The Carreau model is employed as a constitutive equation for blood. In an attempt to obtain the optimal aorto-coronary bypass conditions, the blood flow characteristics are analyzed using in vitro models of the end-to-side anastomotic angles of $45^{\circ}$, $60^{\circ}$ and $90^{\circ}$. To find the optimal graft configurations, the mass flow rates at the outlets of the four models are compared quantitatively. Results: This study finds that Model 3, whose bypass diameter is the same as the inlet diameter of the stenosed coronary artery, delivers the largest amount of blood and the least pressure drop along the arteries. Conclusion: Biomechanical factors are speculated to contribute to the graft patency in coronary artery bypass grafting.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.43-47
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• 2008

Background : Anti-reflux procedures treat gastroesophageal reflux (GER) disease. It is known that gastroesophageal reflux is likelyrelated to the increased incidence of chronic rejection in lung transplantation recipients. Because experimental animal studies areto verify this, we have tried to make an animal model of GER in a rat. Material and Methods : Using the SD rats weighing 250-300 g, we surgically induced gastroesophageal reflux and measured the gastrostomy time under anesthesia. Of three groups, Group I was the control, Group II had lower esophageal and anterior myotomy, and Group III had lower esophageal and anterior myotomy plusdiaphragmatic crural myotomy.The animals were scarified, and lung biopsies and histological examinations were performed 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after gastroesophageal reflux surgery. Results : Baseline animals (n=5) had no GER after charcoal instillation through a gastrostomy tube in Group I. Charcoal-laden macrophages were observed in GroupsII and III. To determine evidence of GER evidence, charcoal was instillated through the gastrostomy tube in group III. In contrast, Group II demonstrated severe neurophil infiltration in the bronchioles and alveolar walls after procedure. After 12 weeks, we observed the disappearance of neurophil, lymphocyte and histiocyte infiltration, and also occasional focal bronchopneumonia and bronchitis. Group III demonstrated neurophil and basophil infiltration in the bronchioles and alveolar walls which was more severe than that in Group II. Interstitial fibrotic changes were observed in Group III.Conclusion : The purpose of our gastroesophageal reflux model was to find evidence of aspiration. There was more evidence of aspiration in Group II than in either of theother two groups.

• Annals of Surgical Treatment and Research
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• v.95 no.6
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• pp.312-318
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• 2018

Purpose: Acute normovolemic hemodilution (ANH) is an autologous transfusion method, using blood collected during surgery, to reduce the need for allogeneic blood transfusion. ANH is controversial because it may lead to various complications. Among the possible complications, anastomotic leakage is one that would have a significant effect on the operation outcome. However, the relationship between ANH and anastomotic site healing requires additional research. Therefore, we conducted this prospective study of ANH, comparing it with standard intraoperative management, undergoing gastric anastomosis in rats. Methods: Sixteen Sprague-Dawley rats were randomly assigned to three groups: group A, surgery with ANH; group N, surgery with standard intraoperative management; and group C, sham surgery with standard intraoperative management. ANH was performed in group A animals by, removing 5.8-6.6 mL of blood and replacing it with 3 times as much crystalloid. All rats were enthanized on postoperative day 6, and histopathologic analyses were performed. Results: The mean hematocrit values, after hemodilution were 22.0% (range, 18.0%-29.0%), group A; 33.0% (29.0%-35.0%), group N; and 32.5% (29.0%-34.0%), group C. There were significant differences between groups A and N (P = 0.019, P = 0.009, P = 0.004, P = 0.039, and P = 0.027), and between groups N and C (P = 0.006, P = 0.027, P = 0.04, P = 0.008, and P = 0.009) with respect to inflammatory cell numbers, neovascularization, fibroblast numbers, edema and necrosis, respectively; there were no differences between groups A and N. Conclusion: In rat model, anastomotic complications did not increase in the ANH group, compared with the standard intraoperative management group.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2269-2272
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• 2013

Matrix metalloproteinases (MMPs) degrade various components of the extracellular matrix and functional polymorphisms in encoding genes may contribute to genetic susceptibility to many cancers. Up to now, associations between MMP-7 (-181A>G) and digestive system cancer risk have remained inconclusive. To better understand the role of the MMP-7 (-181A>G) genotype in digestive cancer development, we conducted this comprehensive meta-analysis encompassing 3,518 cases and 4,596 controls. Overall, the MMP-7 (-181A>G) polymorphism was associated with higher digestive system cancer risk on homozygote comparison (GG vs. AA, OR=1.21, 95% CI = 1.12-1.60) and in a dominant model (GG/GA vs. AA, OR=1.16, 95% CI =1.03-1.46). On subgroup analysis, this polymorphism was significantly linked to higher risks for gastric cancer (GG vs. AA, OR=1.22, 95% CI = 1.02-1.46; GA vs. AA, OR=1.82, 95% CI =1.16-2.87; GG/GA vs. AA, OR=1.13, 95% CI =1.01-1.27; GG vs. GA/AA, OR= 1.25, 95% CI = 1.06-2.39. We also observed increased susceptibility to colorectal cancer and esophageal SCC in both homozygote (OR = 1.13, 95% CI = 1.06-1.26) and heterozygote comparisons (OR = 1.45, 95% CI = 1.11-1.91). In the stratified analysis by controls, significant effects were only observed in population-based studies (GA vs. AA, OR=1.16, 95% CI=1.08-1.50; GA/AA vs. GG, OR=1.10, 95% CI=1.01-1.72). According to the source of ethnicity, a significantly increased risk was found among Asian populations in the homozygote model (GG vs. AA, OR=1.40, 95% CI=1.12-1.69), heterozygote model (GA vs. AA, OR=1.26, 95% CI=1.02-1.51), and dominant model (GG/GA vs. AA, OR=1.18, 95% CI=1.08-1.55). Our findings suggest that the MMP-7 (-181A>G) polymorphism may be a risk factor for digestive system cancer, especially among Asian populations.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.80-82
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• 2015

The mandibuloplasty for the facial aesthetic reason has been the one of the most popular procedures in aesthetic facial bone surgery in East Asia. Most East Asian women prefer smaller-looking and smooth-shaped facial contour. Prominent mandible angle which are common in Asia would be the main problem for smooth facial contour. In addition, recently, the mandibular body and broad chin shape also are known to be remodeled in order to get the ideal smooth facial shape. However, mandibuloplasty is not that easy to cut because many patients has inward mandibular angle and the visual field in operation is limited. The aim of this trial is to try to provide the prefabricated cutting guide for the symmetric and appropriate mandibuloplasty with the surgeons. Preoperative computed tomography(CT) data were processed for the patient and computer simulation model was produced. Then, mandibuloplasty was done on the computer simulation screen. Based on this data, customized cutting guide was made. This prefabricated cutting guide was used in real mandibuloplasty bilaterally. Premade cutting guide for the mandibuloplasty based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the patients in near future.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.356-360
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• 2015

In plastic surgery, patient photography is a vital component of clinical, educational, legal, and research documentation. Optimal acquisition of photographic data requires a dedicated photography studio or a three-dimensional anatomic scanner, both of which are financially impractical for most clinicians. Simplified photo standardization is proposed for use in random clinical settings by using a portable device called the Mirror Stand (MirS). This model device aims to mimic a studio environment by incorporating the basic elements of producing consistent photographs. The pilot MirS is designed for facial photography. Images of 40 random subjects were obtained using the MirS with three different cameras. Real anthropometric measurements of each subject were collected, compared with the photographic measurements, and analyzed. In this study, all three cameras produced equally reliable measurements. Actual facial measurements were comparable to the photogrammetric measurements obtained from photographs taken using the MirS. A constant formula was derived; it allowed the conversion of photographic values into real anthropometric values. The MirS produced consistent photographs with respect to the measurements. The photographs obtained could be translated reliably into their real anthropometric measurements. Therefore, the MirS can be applied in daily practice, providing an efficient alternative for obtaining a standard justifiable photograph.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.