• The Korean Journal of Pain
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• v.9 no.2
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• pp.340-343
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• 1996

Background: In our hospital, stellate ganglion block(SGB) has been performed for the prevention and treatment of vasospasm after microscopic reimplantation of finger(s). If brachial plexus block(BPB) has the same effect of sympathetic block on the upper extremity as SGB, it may be preferable to the SGB because it povides postoperative analgesia and is administered continuously. So we measured and compared the change of skin temperature on the forearm as the parameter of sympathetic blockade after SGB and BPB. Methods: The forty-two patients, belonged to ASA class 1~2, were received BPB for hand surgery. The skin temperature was measured before and after BPB on the forearm with patient monitor(LN 6199, YSI 400 Series Temperature Probe, Hellige, Germany). After 24 hours, ipsilateral SGB was performed and skin temperature was recorded before and after SGB. Results: The increase of skin temperature after procedures was $1.1{\pm}0.5^{\circ}C$(from $34.5{\pm}0.7^{\circ}C$ to $35.6{\pm}0.5^{\circ}C$) in BPB and $0.6{\pm}0.3^{\circ}C$(from $34.9{\pm}0.5^{\circ}C$ to $35.5{\pm}0.5^{\circ}C$) in SGB. The changes of skin temperature in both blocks were statistically significant(p<0.01), and the skin temperatures after each procedure were revealed no significant difference(p$\simeq$0.62). Conclusion: We thought that BPB produced sympathetic blockade on the upper extremity as much as SGB. Moreover, it provides postoperative pain relief and may be employed as continuous BPB could be used for hand surgery with many advantages.

• Journal of the Korean Society of Clothing and Textiles
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• v.31 no.1 s.160
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• pp.119-130
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• 2007

The objects of this study were to investigate responses and peculiarity during local cooling by parts of the human body and to show permissible safety limits without injurious to his health because of excessive cooling when he works hot environments. It were measured rectal temperature, skin temperature, heart rate, total body weight loss, local sweat in back and thigh, clothing microclimate and subjective sensation on 8 subjects and cooling parts were head, neck, chest, abdomen, back, waist, hip, upper arm, forearm, hand, thigh, calf and foot. According to above-mentioned the first experiment, we chose permissible safety limits by parts of the human body for one hour. In the second experiment, it was showed permissible safety limits by parts which examined their safety about health through 4 hours cooling test on 3 subjects. The results are as follows: 1. As a result of the first experiment, we chose permissible safety limits by parts, as follows, head $25^{\circ}C$, neck $20^{\circ}C$, chest $27^{\circ}C$, abdomen $25^{\circ}C$, back $20^{\circ}C$, waist $20^{\circ}C$, upper arm $20^{\circ}C$, forearm $20^{\circ}C$, hand $23^{\circ}C$, thigh $20^{\circ}C$, calf $20^{\circ}C$ and foot $23^{\circ}C$ in $37^{\circ}C$, 50%R.H. environment for 1 hour. 2. As a result of the second experiment, cooling on these safety limits temperatures except chest didn't have a bad effect on health. So it was proved that right permissible safety limits of chest was $28^{\circ}C$. From these results, it has been suggested that skin temperature didn't fall below permissible safety limits when human body was to be cool by parts.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.248-255
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• 2013

Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.9-16
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• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.390-396
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• 2012

Background The radial forearm osteocutaneous free flap is considered to be the standard technique for penile construction. One year after their operation, most patients experience a softened phallus, so that they suffer from difficulties in sexual intercourse. In this report, we present our experience with phalloplasty by radial forearm osteocutaneous free flap, as well as an evaluation of the etiology and treatment of the softened phallus. Methods Between March 2005 and February 2010, 58 patients underwent phalloplasty by radial forearm osteocutaneous free flap. Most of their neophallus had been softened subjectively and among them, 12 patients who wanted correction were investigated. We performed repetitive fat injection, artificial dermis grafting, silicone rod insertion, and rib bone with cartilaginous tip graft. Physical examination, plain radiograph, computed tomography, bone scintigraphy, and satisfaction scores were investigated. Results Most of the participants' penises have been softened after phalloplasty, and the skin elasticity had been also decreased. On plain radiograph, the distal end of the bone was self-rounded; however, the bone shape of the neophallus had no significant interval changes or resorption. Computed tomography showed equivocal density of cortical bone. On bone scintigraphy, the bone metabolism was active at 3 months postoperatively, and remained active 9 years postoperatively. Conclusions The use of a rib bone with cartilaginous tip graft could be an option for improvement of the softened phallus. Silicon rod insertion is also worth considering for rigidity of the softened phallus. Decreased rigidity due to soft tissue atrophy could be alleviated with repeated fat injection and artificial dermis grafting.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.28-34
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• 1998

The traditionally useful coverage methods of the wrist and hand soft tissue defect are the chinese forearm flap, the ulnar forearm flap. But, this flaps are inevitably sacrifice major vessel to the hand. Advantages of the posterior interosseous artery island flap(PIA Flap) is no need to sacrifice blood supply to the hand and supply relatively large thin, good quality flap and more cosmetic than other forearm flaps. But, it is difficult to dissect and raise because of deep seat, close relation with the posterior interosseous nerve and anatomic variation. Authors evaluated 8 cases of 7 patients in the department of orthopaedic surgery, college of medicine, Hallym University from January, 1993 to December, 1995. The results are as follows: 1. The satisfactory coverage was achieved 7 cases and 1 case failed because of anatomic variation. 2 The pedicle length is average 9cm and the flap size is variable from 3cm by 4cm to 5cm by 8cm. 3. The donor site defect was repaired by direct closure in 5 cases, remained 3 cases combined with skin graft. From our experience we conclude that the PIA flap is one of the useful coverage methods of the wrist and hand soft tissue defect.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.71-76
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• 2010

Purpose: The purpose of this study was to examine changes in autonomic nerve responses after low-frequency transcutaneous electrical nerve stimulation (TENS). Methods: Research subjects were 24 students who attend University. Subjects were divided into two groups: 1 = a low intensity group; 2 = a high intensity group. Electrodes were attached to the forearm of the dominant arm and electrical stimuli were administered for 15 minutes. Outcome measures were skin conduction velocity, skin temperature, blood flow, and pulse frequency, each of which was measured a total of 4 times. The data were analyzed using a repeated measures ANOVA. Results: In changes in conduction velocity, the main effect of time variation (in black) was statistically significant. The interaction between time and group main effects was not statistically significant; nor was the difference between the groups. Results showed that skin conduction velocity changed without any relation to group. Conclusions: Low frequency TENS selectively increases skin conduction velocity, which may be helpful for activating sudomotor function regardless of intensity.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.38 no.1
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• pp.75-82
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• 2012

Natural moisturizing factors (NMFs) are hydrophilic and water-soluble components in stratum corneum of the skin. NMFs absorb water from outer environment and enhance the water-holding capacity of stratum corneum and thereby, prevent the dryness and increase flexibility and plasticity of skin. NMFs are mainly composed of amino acids and their metabolites that are produced from the degradation of filaggrin. Here we established a simultaneous quantification method for 22 amino acids in tape-stripped stratum corneum samples using UPLC-PDA. With this method, we analyzed amino acid contents from tape-stripped stratum corneum samples of forearm and forehead regions from 15 healthy volunteers. Amino acid contents of inner (or upper) region were higher than outer (or lower) region of stratum corneum. Amino acid contents of stratum corneum of forearm were higher by 1.5 fold than forehead region. Of note, total amino acid contents were significantly and inversely correlated with trans-epidermal water loss (TEWL), an index for skin barrier function. Especially, Ser, Glu, Gly, Ala and Thr were determined to positively affect skin mositurizing activities. In conclusion, we could demonstrate that amino acid contents of stratum corneum are closely linked with skin barrier and moisturizing function, providing an important and fundamental methodology for the study of amino acids in skin physiology.

• Journal of the Korean Home Economics Association
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• v.30 no.4
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• pp.15-26
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• 1992

To investigate the seasonal effects on physiological responses of human body, clothing micro-climate, and subjective sensation, selected the cloths the most frequently dressed by men in spring and fall, and completed wearing trials in the climatic chamber. The results are as follows: 1. Rectal temp. ranged 36.8-37.1$^{\circ}C$ in either spring or fall, and no seasonal effect was found. 2. In skin temp., there was no seasonal effect in forehead, abdomen, and forearm. Skin temp. of chest was higher in spring than in fall. On the contrary, reverse was true in high and leg. Average skin temp. ranged 32.2-33.2$^{\circ}C$ in spring and 32.9-34.$0^{\circ}C$ in fall. 3. Average total sweat rate of spring, 79.4g/hr, was smaller than that of fall, 110.9g/hr. 4. Clothing temp. ranged 28.1-32.8$^{\circ}C$ in spring and 27.6-31.$0^{\circ}C$ in fall. Clothing humidity ranged 36.9-48.9% in spring and 38.2-51.1% in fall. Therefore, clothing microclimate was higher during fall than during spring. As results, skin temp. of the body core except chest did not show seasonal variation, but there was obvious seasonal variation in skin temp. of the extremities. Therefore, seasonal variation should be take into consideration in the experiments related to the cloth. In addition, standard for each season and the degree of work performance should be re-established in clothing micro-climate.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.