• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2015.05a
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• pp.622-624
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• 2015

Tumor hypoxia caused by the unique characteristics of solid tumor sites such as lowered vascular density, irregular vasculature, longitudinal oxygen gradient, and unbalanced oxygen consumption has decreased therapeutic efficacy in several clinical trials such as radiation, chemotherapy, and surgery. Hence, tumor oxygenation studies at microvascular levels are important to provide better understanding of the complexity of microvasculature oxygen transport and exchange with tissue. However, polarographic microelectodes, was employed to measure $pO_2$ at the microvasculature level, but it is difficult to perform and does not provide significant spatial and temporal information of oxygen delivery. In this research, we introduce the hyperspectral imaging system able to provide a wide range of vascular characteristics by spatial maps on hemoglobin saturation information for better understanding of the relationship between blood oxygen delivery, hypervascularity, aberrant angiogenesis at microvasculature levels during tumor growth.

• Journal of the Optical Society of Korea
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• v.15 no.4
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• pp.373-379
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• 2011

Current therapeutic methods for suppressing muscle spasticity are intensive functional training, surgery, or pharmacological interventions. However, these methods have not been fully supported by confirmed efficacy due to the aggravation of the muscle spasticity in some patients. In this study, a combined system was developed to treat with a low-level laser and to monitor the region of the treatment using an optical spectroscopic probe that measures oxygen saturation and deoxygenation during low-level laser therapy (LLLT). The evaluation of the wavelength dependence for LLLT was performed using a Monte Carlo simulation and the results showed that the greatest amount of heat generation was seen in the deep tissue at ${\lambda}$ = 830 nm. In the oxy- and deoxygenation measurements during and after the treatment, oxygen-Hb concentration was significantly increased in the laser-irradiated group when compared to the control group. These findings suggest that LLLT using ${\lambda}$ = 830 nm may be of benefit in accelerating recovery of muscle spasticity. The combined system that we have developed can monitor the physiological condition of muscle spasticity during the laser treatment in real time and may also be applied to various myotonia conditions such as muscle fatigue, back-pain treatment/monitoring, and ulcer due to paralysis.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.546-550
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• 2012

Background This study was designed to introduce the feasibility of toe tissue transfer without venous outflow for fingertip reconstruction. Methods Five cases of fingertip defects were treated successfully with this method. Four cases were traumatic fingertip defects, and one case was a hook-nail deformity. The lateral pulp of a great toe or medioinferior portion of a second toe was used as the donor site. An arterial pedicle was dissected only within the digit and anastomosis was performed within 2 cm around the defect margin. The digital nerve was repaired simultaneously. No additional dissection of the dorsal or volar pulp vein was performed in either the donor or recipient sites. Other surgical procedures were performed following conventional techniques. Postoperative venous congestion was monitored with pulp temperature, color, and degree of tissue oxygen saturation. Venous congestion was decompressed with a needle-puncture method intermittently, but did not require continuous external bleeding for salvage. Results Venous congestion was observed in all the flaps, but improved within 3 or 4 days postoperatively. The flap size was from $1.5{\times}1.5cm^2$ to $2.0{\times}3.0cm^2$. The mean surgical time was 2 hours and 20 minutes. A needle puncture was carried out every 2 hours during the first postoperative day, and then every 4 hours thereafter. The amount of blood loss during each puncture procedure was less than 0.2 mL. In the long-term follow-up, no flap atrophy was observed. Conclusions When used properly, the free toe tissue transfer without venous anastomosis method can be a treatment option for small defects on the fingertip area.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.507-513
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• 1990

We experienced an intraatrial baffle repair for unroofed coronary sinus syndrome in TOF. The patient was a 32-month old female, with complaints of cyanosis, exertional dyspnea and growth retardation. Physical examination showed cyanosis of lip, clubbing of finger, growth retardation and systolic murmur[0 /Gr VI] on left sternal border. With an aid of noninvasive and invasive diagnostic procedure, the patient was diagnosed as TOF combined with unroofed coronary sinus syndrome and LSVC connecting to left atrium. After patch closure of VSD, infundibulectomy and pulmonary valvotomy, the intraatrial baffle redirection of anomalous LSVC to right atrium was undertaken. The Dacron baffle was constructed along the roof of the left atrium to the plane of the atrial septum. The intraatrial septum was then reconstructed with Dacron which was sutured to residual septal tissue. After surgery, the systemic oxygen saturation was elevated to 95.5%, as compared with preoperative value 61%. The postoperative course was uneventful.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.109-116
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• 2017

Background The effect of liposuction on the perforators of the lower abdominal wall has been investigated in several studies. There are controversial results in the literature that have primarily demonstrated the number and patency of the perforators. The aim of this study was to determine the effect of liposuction on the perfusion of perforator-based abdominal flaps using a combined laser-Doppler spectrophotometer (O2C, Oxygen to See, LEA Medizintechnik). Methods Nine female patients undergoing classical abdominoplasty were included in the study. Perforators and the perfusion zones of the deep inferior epigastric artery flap were marked on the patient's abdominal wall. Flap perfusion was quantitatively assessed by measuring blood flow, velocity, capillary oxygen saturation, and relative amount of hemoglobin for each zone preoperatively, after tumescent solution infiltration, following elevation of the flap on a single perforator, and after deep and superficial liposuction, respectively. Results The measurements taken after elevation of the flap were not significantly different than measurements taken after the liposuction procedures. Conclusions The liposuction procedure does not significantly alter the perfusion of perforator-based abdominal flaps in the early period. The abdominal tissue discarded in a classic abdominoplasty operation can be raised as a perforator flap and has been demonstrated to be a unique model for clinical research.

• Archives of Plastic Surgery
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• v.42 no.1
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• pp.59-67
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• 2015

Background Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. Methods Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. Results Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). Conclusions By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.

• Journal of Life Science
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• v.13 no.1
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• pp.42-46
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• 2003

Photoplethysmogram is widely used to measure heart rate and arterial blood oxygen saturation in human. This paper describes radial pulse waves recorded by photoplethysmogram with 940 nm wavelength infra red light. Radial pulse waves were varied according to the recording site. When recorded on the skin over radial artery, the radial pulse wave was inverted, comparing to the photoplethysmogram at fingertip. The mechanism of inverted pulse wave seemed to be caused by the change of the blood volume in the subcutaneous tissue between radial artery and the skin, which was reduced during systolic period and increased during diastolic period of the cardiac cycle. These results suggest that radial arterial wall may reflect infra red ray.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.13-18
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• 1980

The ultimate goal of treatment of carton monoxide poisoning is to promote dissociation of carboxyhemoglobin and to maintain arterial $PO_2$ above 50mmHg throughout the course of treatment to protect vital organs from damage caused by hypoxia. The hyperbaric chamber designed and manufactured for this purpose has obviousely made an enormous contribution and yet has several handicaps to be overcome by any means. These handicaps are: the financial impact to purchase the chamber (especially in a small, remote community), an extra manpower requirement to operate the device, limitation in the capacity of the chamber (one man type), and the possible hazard of oxygen intoxication and dysbarism. The primary objective of this study is to develope a new therapeutic measure as an alternative to the hyperbaric chamber when it is not available or contraindicated. The effect of intestinal perfusion with hydrogen peroxide has been studied by many investigators and was known to be an excellent way of extrapulmonary oxygen supply. the advantage of this method will include; 1) much more amount of oxygen is delivered to the tissue than one would expect from 100% saturation with oxygen at 1 ata, 2) the procedure is simple and most economical, 3) neither sophisticated equipment nor extra manpower is required. As a study preliminary to the clinical application, authors conducted a series of experiment to observe the effect of hydrogen peroxide enema on dissociation of carboxyhemoglobin in intoxicated rabbit blood. Using an animal gas chamber, 20 rabbits were exposed to CO gas of 6,000 ppm for 60 minutes. Ten rabbits of control group were given 10cc of warmed normal saline solution by reactal perfusion and for the other 10 of the experimental group, the same amount of 1% $H_{2}O_{2}$ solution was given by the same way. Two blood specimens were drawn from each rabbit: the first one immediately following the exposure and the second one after rectal perfusion, about 30 minutes after the first sampling. The result was as follows; 1) The decrease in carboxyhemoglobin concentration during the first 30 minutes in the control and experimental group were $18.18{\pm}4.49%\;and\;23.03{\pm}4.13%$ respectively shelving the significant difference (p<0.05) between the two groups. 2) Hemoglobin and hematocrit value showed no significant difference between two groups and not altered significantly by intestinal perfusion with $H_{2}O_{2}$.

• Journal of Chest Surgery
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• v.33 no.6
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• pp.445-468
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• 2000

Background: Retrograde cerebral perfusion(RCP) is currently used for brain protection during aorta surgery, however, for the safety of it, various data published so far are insufficient. We performed RCP using pig and investiaged various parameters of cerebral metabolism and brain injury after RCP under deep hypothermia. Material and Method: We used two experimental groups: in group I(7 pigs, 20 kg), we performed RCP for 120 minutes and in group II (5 pigs, 20 kg), we did it for 90 minutes. Nasopharyngeal temperature, jugular venous oxygen saturation, electroencephalogram were continuously monitored, and we checked the parameters of cerebral metabolism, histological changes and serum levels of neuron-specific enolose(NSE) and lactic dehydrogenase(LDH). Central venous pressure during RCP was mainained in the range of 25 to 30 mmHg. Result: Perfusion flow rates(ml/min) during RCP were 130$\pm$57.7(30 minutes), 108.6$\pm$55.2(60 minutes), 107.1$\pm$58.8(90 minutes), 98.6$\pm$58.7(120 minutes) in group I and 72$\pm$11.0(30 minutes), 72$\pm$11.0(60 minutes), 74$\pm$11.4(90 minutes) in group II. The ratios of drain flow to perfusion flow were 0.18(30 minutes), 0.19(60 minutes), 0.17(90 minutes), 0.16(120 minutes) in group I and 0.21, 0.20, 0.17 in group II. Oxygen consumptions(ml/min) during RCP were 1.80$\pm$1.37(30 minutes), 1.72$\pm$1.23(60 minutes), 1.38$\pm$0.82(90 minutes), 1.18$\pm$0.67(120 minutes) in group I and 1.56$\pm$0.28(30 minutes), 1.25$\pm$0.28(60 minutes), 1.13$\pm$0.26(90 minutes). We could observe an decreasing tendency of oxygen consumption after 90 minutes of RCP in group I. Cerebrovascular resistance(dynes.sec.cm-5) during RCP in group I incrased from 71370.9$\pm$369145.5 to 83920.9$\pm$49949.0 after the time frame of 90 minutes(p<0.05). Lactate(mg/min) appeared after 30 minutes of RCP and the levels were 0.15$\pm$0.07(30 minutes), 0.18$\pm$0.10(60 minutes), 0.19$\pm$0.19(90 minutes), 0.18$\pm$0.10(120 minutes) in group I and 0.13$\pm$0.09(30 minutes), 0.19$\pm$0.03(60 minutes), 0.29$\pm$0.11(90 minutes) in group II. Glucose utilization, exudation of carbon dioxide, differences of cerebral tissue acidosis between perfusion blood and drain blood were maintained constantly during RCP. Oxygen saturation levels(%) in drain blood during RCP were 22.9$\pm$4.4(30 minutes), 19.2$\pm$4.5(60 minutes), 17.7$\pm$2.8(90 minutes), 14.9$\pm$2.8(120 minutes) in group I and 21.3$\pm$8.6(30 minutes), 20.8$\pm$17.6(60 minutes), 21.1$\pm$12.1(90 minutes) in group II. There were no significant changes in cerebral metabolic parameters between two groups. Differences in serum levels of NSE and LDH between perfusion blood and drain blood during RCP showed no statistical significance. Serum levels of NSE and LDH after resuming of cardipulmonary bypass decreased to the level before RCP. Brain water contents were 0.73$\pm$0.03 in group I and 0.69$\pm$0.06 in group II and were higher than those of the controls(p<0.05). The light microscopic findings of cerebral neocortex, basal ganglia, hippocampus(CA1 region) and cerebellum showed no evidence of cerebral injury in two groups and there were no different electron microscopy in both groups(neocortex, basal ganglia and hippocampus), but they were thought to be reversible findings. Conclusion: Although we did not proceed this study after survival of pigs, we could perform the RCP successfully for 120 minutes with minimal cerebral metabolism and no evidence of irreversible brain damage. The results of NSE and LDH during and after RCP should be reevaluated with survival data.

• Journal of Home Health Care Nursing
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• v.25 no.3
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• pp.153-163
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• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.