• 한국임상수의학회지
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• 제24권2호
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• pp.114-118
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• 2007

The objective of this study was to investigate the effects of implanted chitosan applied to surgically created wound in pigs. Six healthy $2{\sim}3$ months old Landrace and Yorkshire mixed breeds of both genders were used. A 2 cm straight skin incision was made and undermined skin ($2{\times}2cm$) over on the each pig's both sides of dorsal midline at 0, 7. 14 and 18 days. One wound (left side) was implanted 0.4 mg of cotton type chitosan and other wound was treated saline (3 ml). Each wound was closed with two interrupted suture of 2-0 sutures. The wounds created at 18, 14.7 and 0 days were named post-wounding day (PWD) 3, 7, 14 and 21, respectively. At 21 days after initial wounding, each wound was taken for histological observations. Reepithelialization tended to be greater in the chitosan group than in the control group at PWD 3 and 14. Granulation tissue formation did not show especial differences in two groups. Number of inflammatory cells was lesser statistically in level in the chitosan group than those in the control group at 21 days after wounding (p<0.05). Fibroblasts and neovasculature tended to be greater in the chitosan group than in the control group at PWD 3 and 7, and tended to be lesser in the chitosan group than in the control group at PWD 14 and 21. Collagen and fibrin were observed to be evenly distributed around the wound in the chitosan group. But collagen and fibrin were observed to be converged along the wound in the control group.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.8-14
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• 2017

Objective : The purposes of this study were to introduce a superficial temporal artery (STA)-sparing mini-pterional approach for the treatment of cerebral aneurysms and review the surgical results of this approach. Methods : Between June 2010 and December 2015, we performed the STA-sparing mini-pterional approach for 117 patients with 141 unruptured intracranial aneurysms. We analyzed demographic, radiologic, and clinical variables including age, sex, craniotomy size, aneurysm location, height of STA bifurcation, and postoperative complications. Results : The mean age of patients was 58.4 years. The height of STA bifurcation from the superior border of the zygomatic arch was $20.5mm{\pm}10.0$ (standard deviation [SD]). The craniotomy size was $1051.6mm^2{\pm}206.5$ (SD). Aneurysm neck clipping was possible in all cases. Intradural anterior clinoidectomy was performed in four cases. Contralateral approaches to aneurysms were adopted for four cases. Surgery-related complications occurred in two cases. Permanent morbidity occurred in one case. Conclusion : Our STA-sparing mini-pterional approach for surgical treatment of cerebral aneurysms is easy to learn and has the advantages of small incision, STA sparing, and a relatively wide surgical field. It may be a good alternative to the conventional pterional approach for treating cerebral aneurysms.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.86-92
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• 2011

Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78 mm and 48 mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.69-74
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• 2021

Background In inferomedially rotated zygomatic fractures sticking in the maxillary sinus, it is often difficult to achieve complete reduction only by conventional intraoral reduction. We present a new intraoral reduction technique using a Kirschner wire and its clinical outcome. Methods Among 39 inferomedially impacted zygomatic fractures incompletely reduced by a simple intraoral reduction trial with a bone elevator, a Kirschner wire (1.5 mm) was vertically inserted from the zygomatic body to the lateral orbital rim in 17 inferior-dominant rotation fractures and horizontally inserted to the zygomatic arch in nine medial-dominant and 13 bidirectional rotation fractures. A Kirschner wire was held with a wire holder and lifted in the superolateral or anterolateral direction for reduction. Following reduction of the zygomaticomaxillary fracture, internal fixation was performed. Results Fractures were completely reduced using only an intraoral approach with Kirschner wire reduction in 33 cases and through an additional lower lid or transconjunctival incision in six cases. There were no surgical complications except in one patient with undercorrection. Postoperative 6-month computed tomography scans showed complete bone union and excellent bone alignment. Four patients experienced difficulty with upper lip elevation; however, these problems spontaneously resolved after manual tissue lump massage and intralesional steroid (Triamcinolone) injection. Conclusions We completely reduced infraorbital rim fractures, zygomaticomaxillary buttresses, and zygomaticofrontal suture fractures in 84% of patients through an intraoral approach alone. Intraoral Kirschner wire reduction may be a useful option by which to obtain effective and powerful reduction motion of an inferomedially rotated zygomatic body.

• 대한심미치과학회지
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• 제29권2호
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• pp.84-91
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• 2020

치주질환으로 손상된 치간유두의 재생은 아주 도전적인 과제이다. 지금까지 많은 치과의사들이 훌륭한 수술적인 방법을 고안하여 소개하였다. 지금까지 소개된 술식들을 순서대로 비교해보고 장단점을 비교해 치간유두를 재생을 위한 최적의 방법을 고안해보았다. 치주수술만으로 해결하기 어려운 좁은 치간유두 사이의 공간을 부분교정치료를 통하여 공간을 일시적으로 만들어 주는 것이 치은이식을 위해 큰 도움이 되었다. 치은이식은 마이크로 블레이드를 이용하여 박리를 시행하고 치은경계부에서 떨어진 수직절개를 하나만 시행해 여기를 통해 추가적인 박리와 이식편을 넣어서 치은이식을 시행하였다. 이렇게 교정치료를 동반하여 좁은 치간유두 사이의 폭을 벌려서 치은이식이 더 용이한 상태로 만들어 치은이식을 진행하고, 치은이 성숙한 뒤 교정력으로 다시 치아사이를 모아주는 술식(ELSA technique)을 통해 치간유두 재생을 할 수 있었다.

• 대한심미치과학회지
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• 제30권2호
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• pp.91-101
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• 2021

치간유두의 Connective Tissue Graft (CTG)는 좁은 공간 때문에 아주 까다롭다. 그래서 치간유두의 재생은 아주 도전적인 과제라고 생각한다. 이렇게 인접치와의 좁은공간에서 잇몸이식은 아주어렵지만, 3mm의 공간을 만들 수 있다면 CTG는 그렇게 어렵지 않다. 그래서 교정력을 이용하여 임시적으로 3mm의 공간을 만들어 주고 잇몸이식을 진행하였다. CTG는 마이크로블레이드를 이용하여 치은박리를 시행하였고, 치아사이의 공간에 수직절개를 만들어 그곳을 이용해서 결합조직을 이식하였다. 유지기간후에 교정력을 이용해 다시 치아사이의 공간을 모아서 치아를 배열하였다. 이 방법을 통해 치아사이의 치간유두를 재생하였고 이 술식을 이름을 ELSA (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla)로 이름지었다. 치주질환 등으로 치간유두가 소실된 경우, ELSA technique을은 치간유두를 재생하는 아주 효과적인 방법이다.

• Journal of Korean Neurosurgical Society
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• 제65권2호
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• pp.307-314
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• 2022

Objective : The percutaneous thread transection technique is a surgical dissecting method using a dissecting thread inserted through a needle under ultrasound guidance without skin incision. As the new dissecting threads were developed domestically, this cadaver study was conducted to compare the effectiveness and safety between the new threads (ultra V sswire and smartwire-01) and a pre-existing commercial dissecting thread (loop & shear) by demonstrating a modified looped thread cubital tunnel release. Methods : The percutaneous cubital tunnel release procedure was performed on 29 fresh cadaveric upper extremities. The pre-existing commercial thread was used in 5 upper extremities. The two newly developed threads were used in 24 upper extremities. Two practitioners performed the procedures separately. After the modified looped thread cubital release, anatomical and histological analyses were performed by a blinded anatomist. The presence of the dissected cubital tunnel and damaged adjacent soft tissue was assessed. Results : Out of the 29 cadaveric upper extremities, 27 specimens showed complete dissection of the Osborne ligament and the proximal fascia of the flexor carpi ulnaris muscle. One specimen was incompletely dissected in each of the ultra V sswire and smartwire-01 groups. There were no injuries of adjacent structures including the ulnar nerve, ulnar artery, medial antebrachial cutaneous nerve, or flexor tendon with either the commercial thread or the newly developed threads. The anatomical analysis revealed clear and sharp incisional margins of the cubital tunnel in the Smartwire-01 and loop & shear groups. All three kinds of threads maintained proper linear elasticity for easy handling during the procedure. The smartwire-01 provided higher visibility in ultrasound than the other threads. Conclusion : The newly developed threads were effective and safe for use in the thread cubital tunnel release procedure.

• 한국의류산업학회지
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• 제25권4호
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• pp.508-519
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• 2023

Muscle reduction owing to aging causes changes in physical function among the elderly. Fitness compression wear reduces fatigue by compressing the main muscles, expanding blood vessels, and rapidly discharging lactic acid. The effect of clothing pressure when wearing fitness compression wear for the elderly was objectively and subjectively evaluated for six women aged 55-64 years. The evaluation clothes were three types of tops and bottoms, one type of design (A) preferred among the existing compression wear, and two types of design (B and C). The objective evaluation items included clothing pressure, blood flow, surface temperature, and subjective satisfaction. It was found that clothing A had the highest clothing pressure in the straight posture and five fitness movements. Blood flow increased the most when wearing the evaluation clothing. The surface temperature was found to be the highest for clothing C, and subjective satisfaction was found to be the best when wearing evaluation clothing B. If the tensile strength was low and the tensile elongation was high, as in evaluation clothing B, it was recognized as appropriate clothing pressure, and the subject was subjectively satisfied. When manufacturing fitness compression wear in the future, it will be possible to increase users' objective and subjective satisfaction with wearing it, if the incision of the garment were placed at the location of the line of non-extension (LoNE), and appropriate material characteristics are applied.

• The Korean Journal of Pain
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• 제36권1호
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• pp.11-50
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• 2023

As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.

• 대한두개안면성형외과학회지
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• 제24권5호
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• pp.223-229
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• 2023

Background: Preauricular sinus (PAS) is a common congenital anomaly, and complete excision is recommended to prevent recurrence. However, PAS has a high recurrence rate as a result of incomplete removal due to the high variability of the sinus ramifications, making its treatment challenging. In this study, we standardized the surgical procedure to reduce the complications and recurrence rate and compared the postoperative results between the non-standardized and the standardized groups. Methods: This retrospective study included 97 patients (120 ears) who had undergone PAS excision by a single surgeon between October 2014 and September 2022 and underwent at least 6 months of follow-up. After October 2018, all patients were treated using the standardized method, which comprised the use of magnifying glasses, exploration with a lacrimal probe, the use of methylene blue staining, and excision of a piece of surrounding normal tissue and related cartilage in continuity with the specimen. There were 38 patients (45 ears) in the non-standardized group and 59 patients (75 ears) in the standardized group. Results: Recurrence was observed in six of 120 ears, indicating an overall recurrence rate of 5.0%. Recurrence occurred in five ears (11.1%) in the non-standardized group and one ear (1.3%) in the standardized group. The standardized group had a significantly lower recurrence rate (p= 0.027) than the non-standardized group. Conclusion: We defined a standardized sinectomy protocol and used it for the surgical treatment of PAS. With this standardized method, we were able to reduce the rates of complications and recurrence without the use of a long incision.