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Clinical Experience of the Brushite Calcium Phosphate Cement for the Repair and Augmentation of Surgically Induced Cranial Defects Following the Pterional Craniotomy

  • Ji, Cheol;Ahn, Jae-Geun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.3
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    • pp.180-184
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    • 2010
  • Objective : To prevent temporal depression after the pterional craniotomy, this study was designed to examine the safety and aesthetic efficacy of the brushite calcium phosphate cement (CPC) in the repair and augmentation of bone defects following the pterional craniotomy. Methods : The brushite CPC was used for the repair of surgically induced cranial defects, with or without augmentation, in 17 cases of pterional approach between March, 2005 and December, 2006. The average follow-up month was 20 with range of 12-36 months. In the first 5 cases, bone defects were repaired with only brushite CPC following the contour of the original bone. In the next 12 cases, bone defects were augmented with the brushite CPC rather than original bone contour. For a stability monitoring of the implanted brushite CPC, post-implantation evaluations including serial X-ray, repeated physical examination for aesthetic efficacy, and three-dimensional computed tomography (3D-CT) were taken 1 year after the implantation. Results : The brushite CPC paste provided precise and easy contouring in restoration of the bony defect site. No adverse effects such as infection or inflammation were noticed during the follow-up periods from all patients. 3D-CT was taken 1 year subsequent to implantation showed good preservation of the brushite CPC restoration material. In the cases of the augmentation group, aesthetic outcomes were superior compared to the simple repair group. Conclusion : The results of this clinical study indicate that the brushite CPC is a biocompatible alloplastic material, which is useful for prevention of temporal depression after pterional craniotomy. Additional study is required to determine the long-term stability and effectiveness of the brushite calcium phosphate cement for the replacement of bone.

The emergency patients analysis of 1339 Emergency Medical Information Center received during the holidays - New Year's Day & Thanksgiving Day of Gwangju & Jeonnam region in 2007 - (연휴동안 1339 응급의료정보센터에 접수된 응급환자 현황 분석 - 광주·전남지역의 2007년 구정과 추석을 중심으로 -)

  • Park, Si-Goo;Park, Hee-Jin
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.1
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    • pp.69-80
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    • 2008
  • During New year's day and Thanksgiving holiday, the 1339 Information Center in Gwangju and Jeonnam received an emergency medical situation and carried out the analysis as follows ; 1. The reason for the higher phone guidance(72%) of the hospital was based on the simple query for the pain control rather than emergency care. This was explained by the unfamiliar environment of the holiday movers. Pharmaceutical guidance(12.6%) in rural area was also given during the holidays. 2. The disease counselling(2.4%) and emergency treatment instruction(First Aid)(1.6%) decreased because of the small number of request for the diseases. This explained the decrease of the disease counselling. 3. The phone calls increased 8-13 times more than usual. Five-day holidays could have more emergency patients than three-day holidays. During New year's day and Thanksgiving day, the number of received phone calls was 6,444(25.7%) and this accounted for one fourth of the total number in 2007. 4. The number of the patients increased on New year's day and Thanksgiving day because most of the medical institutions and pharmacy were off duty. 5. The patients were centered in Internal medicine and pediatrics. This showed the food-borne diseases and air-borne infection such as common cold. 6. During Thanksgiving day, ophthalmologic patients having viral keratoconjunctivitis(Apollo eye disease) increased 8 folds than in New year's day. It was estimated from the continuous epidemic of Apollo eye disease. 7. There broke out the traffic accidents, food poisoning, infectious diseases, dermatological diseases due to seasonal and environmental changes during the holiday move.

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PCR Detection Method for Rapid Diagnosis of Bacterial Canker Caused by Clavibacter michiganensis on Tomato (토마토 궤양병 신속 진단을 위한 Clavibacter michiganensis의 PCR 검출법)

  • Park, Mi-Jeong;Back, Chang-Gi;Park, Jong-Han
    • Research in Plant Disease
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    • v.24 no.4
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    • pp.342-347
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    • 2018
  • Bacterial canker caused by Clavibacter michiganensis is considered to be one of the most serious diseases, leading to economic damage to tomato worldwide. Diagnosis of the bacterial canker on tomato is known to be difficult because the causal pathogen is slow-growing on artificial media as well as causes latent infection in tomato. In this study, as a less time-consuming method, a specific primer set was newly designed for rapid detection of C. michiganensis. The method presented here is so simple, easy, and fast that it can be useful and practical in direct detection of the bacterial canker pathogen from tomato plants.

A Study on Key Protection Method based on WhiteBox Cipher in Block Chain Environment (블록체인 환경에서 화이트박스 암호기반 키 보호 기법에 관한 연구)

  • Choi, Do-Hyeon;Hong, Chan-Ki
    • Journal of Convergence for Information Technology
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    • v.9 no.10
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    • pp.9-15
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    • 2019
  • Recently, in the field of next-generation e-commerce and finance, interest in blockchain-based technologies such as Bitcoin and Ethereum is great. Although the security of blockchain technology is known to be secure, hacking incidents / accidents related to cryptocurrencies are being issued. The main causes were vulnerabilities in the external environment, such as taking over login sessions on cryptocurrency wallets, exposing private keys due to malware infection, and using simple passwords. However, private key management recommends general methods such as utilizing a dedicated application or local backup and physical archiving through document printing. In this paper, we propose a white box password-based private key protection scheme. As a result of safety and performance analysis, we strengthened the security against vulnerability of private key exposure and proved the processing efficiency of existing protocol.

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

  • Suh, Dongwhan;Ji, Jong-Hun;Tankshali, Kirtan;Kim, Eung-Sic
    • Clinics in Shoulder and Elbow
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    • v.22 no.4
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    • pp.220-226
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    • 2019
  • Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up. Methods: From November 2008 to December 2016, 23 patients ($57.5{\pm}4.4years$; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was $4.7{\pm}4.0years$ (range, 2-12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated. Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last followup (p<0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (p=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study. Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

Nasal alar rim redraping method to prevent alar retraction in rhinoplasty for Asian men: A retrospective case series

  • Choi, Jun Ho;Yoo, Hyokyung;Kim, Byung Jun
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.3-9
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    • 2021
  • Background For an attractive and natural tip contour in Asian rhinoplasty, insertion of a nasal implant and reinforcement of the cartilaginous framework are essential. However, scar contracture, which often results from augmentation with implant insertion and inadequate soft tissue coverage of the framework, is one of the most common causes of alar retraction. This study reports a novel method of redraping soft tissue along the alar rim to prevent alar retraction in Asians. Methods Twenty young Asian men who underwent primary rhinoplasty with septoplasty were retrospectively reviewed. After the usual rhinoplasty procedures, alar rim redraping was conducted for the soft tissue along the transcolumellar and bilateral infracartilaginous incisions. The longest axis of the nostril (a) and the height of the nostril from that axis (b) were measured in anterior-posterior and lateral views. The preoperative and postoperative ratios (b/a) were analyzed using the paired t-test. Results All 20 patients showed natural contours of the nasal tip, nostrils, and alae after a mean follow-up of 53.6 weeks (range, 52-60 weeks). The ratio of the nostril axes significantly decreased postoperatively in all patients except one, by an average of 11.08%±6.52% in the anterior-posterior view and 17.74%±8.49% in the lateral view (P<0.01). There were no complications, including asymmetry, contracture, subdermal plexus injury, flap congestion, or infection. Conclusions A quantitative analysis of alar retraction by evaluating the ratio of nostril axes showed that alar rim redraping is a simple and effective adjuvant technique for preventing alar retraction in rhinoplasty for young Asian men.

WALANT: A Discussion of Indications, Impact, and Educational Requirements

  • Shahid, Shahab;Saghir, Noman;Saghir, Reyan;Young-Sing, Quillan;Miranda, Benjamin H.
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.531-537
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    • 2022
  • Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

Knowledge, Attitudes and Perceptions Regarding Endemic Vivax Malaria in Inhabitants and Patients in Two Cities of Northern Gyeonggi-do, Korea, 2020

  • Bahk, Young Yil;Cho, Shin-Hyeong;Park, Sookkyung;Kwon, Jeongran;Kan, Hyesu;Kim, Miyoung;Na, Byoung-Kuk;Hong, Sung Jong;Kwon, Hyung Wook;Kim, Tong-Soo
    • Parasites, Hosts and Diseases
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    • v.59 no.6
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    • pp.595-605
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    • 2021
  • An understanding of the knowledges, attitudes and perceptions of different populations is key for public health policy makers. Here, a survey was performed on knowledge, attitudes, and perceptions about malaria diagnosis, prevention, control, and treatment. The 407 survey participants included both uninfected inhabitants and patients from 2 cities (Gimpo- and Paju-si) of Northern Gyeonggi-do, known as high-risk areas for vivax malaria. We used community-based study design and non-probability sampling method using the primary data. Association between variables were tested using χ2-tests. In general, the information on malaria reported by the participants in this study was unsystematic and included inaccurate details. The knowledge of malaria symptoms, identified as headache, chills and fever, was high, but the surveyed community lacks knowledge of the specific medications used for malaria treatment, with a large number of respondents having no knowledge of any form of medication. Survey questions with high correct answer rates included questions about easy treatment of malaria in Korea, the high daytime activity of malaria-borne mosquitoes, and the infection risk posed by outdoor activities. However, a large portion of the respondents was unable to provide simple medical and biological information about the disease. This study aimed to comprehensively evaluate the knowledge, attitude, and practical behavior of the surveyed community with respect to malaria and the implications reported here could be applicable to other malaria endemic areas in Korea.

Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population

  • Tankshali, Kirtan;Suh, Dong-Whan;Ji, Jong-Hun;Kim, Chang-Yeon
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.125-134
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    • 2021
  • Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

Inactivated Vibrio cholerae Strains That Express TcpA via the toxT-139F Allele Induce Antibody Responses against TcpA

  • Eun Jin Kim;Jonghyun Bae;Young-Jun Ju;Do-Bin Ju;Donghyun Lee;Seonghyeon Son;Hunseok Choi;Thandavarayan Ramamurthy;Cheol-Heui Yun;Dong Wook Kim
    • Journal of Microbiology and Biotechnology
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    • v.32 no.11
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    • pp.1396-1405
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    • 2022
  • Cholera remains a major global public health problem, for which oral cholera vaccines (OCVs) being a valuable strategy. Patients, who have recovered from cholera, develop antibody responses against LPS, cholera toxin (CT), toxin-coregulated pilus (TCP) major subunit A (TcpA) and other antigens; thus, these responses are potentially important contributors to immunity against Vibrio cholerae infection. However, assessments of the efficacy of current OCVs, especially inactivated OCVs, have focused primarily on O-antigen-specific antibody responses, suggesting that more sophisticated strategies are required for inactivated OCVs to induce immune responses against TCP, CT, and other antigens. Previously, we have shown that the toxT-139F allele enables V. cholerae strains to produce CT and TCP under simple laboratory culture conditions. Thus, we hypothesized that V. cholerae strains that express TCP via the toxT-139F allele induce TCP-specific antibody responses. As anticipated, V. cholerae strains that expressed TCP through the toxT-139F allele elicited antibody responses against TCP when the inactivated bacteria were delivered via a mouse model. We have further developed TCP-expressing V. cholerae strains that have been used in inactivated OCVs and shown that they effect an antibody response against TcpA in vivo, suggesting that V. cholerae strains with the toxT-139F allele are excellent candidates for cholera vaccines.