• Archives of Plastic Surgery
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• v.36 no.6
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• pp.773-778
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• 2009

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.139-148
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• 1999

Since Nakayama's first report about venous flap, many experimental and clinical studies were done about this new type of flap. And due to its various benefits, its applications as arterialized venous free flap type have increased recently. In this study we have attempted to reconstruct composite of defects of the hand with new modification of arterialized venous free flap and simultaneous reconstruction of skin, nerve, tendon were performed successfully. From 1994 to 1999, the defects of the hands in 35 patients were reconstructed with various modifications of arterialized venous free flaps. The range of age was from 19 to 55 years and size of flap ranged from $1{\times}2cm\;to\;14{\times}9cm$. Among them, 12 cases of flap over 20cm in size were included. Indications of flaps were as follows: resurfacing of the defects of the skin (9 cases), simultaneous reconstruction of extensor, skin and digital nerve(2 cases), reconstruction of the skin with extensor(5 cases), as a flap-through type vascular reconstruction(6 cases), for digital nerve reconstruction(2 cases), contracture release(3 cases), and finger tip reconstruction(9 cases). All of the cases except one survived with marginal skin necrosis less than 10%. And relatively large flaps over 20cm in size successfully survived without any delay procedures. Composite reconstructions including tendon and nerve were successful with new modifications of this flap. Arterialized venous free flap is one of the useful procedure in reconstruction of the hand because it has many advantages such as non-bulky and good quality of flap, variable length of pedicle, preservation of major vascular pedicle, less operation time, single operative field and in addition possibility of various modifications.

• Macromolecular Research
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• v.17 no.9
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• pp.703-708
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• 2009

Silk fibroin scaffolds were examined as a biomaterial option for tissue-engineered cartilage-like tissue. In tissue engineering for cartilage repair using a scaffold, initial chondrocyte-material interactions are important for the following cell behaviors. In this study, the surface of nanofibrous silk fibroin (NSF) meshes was modified by a microwave-induced argon plasma treatment in order to improve the cytocompatibility of the meshes used as cartilaginous grafts. In addition, the effects of a plasma treatment on the cellular behavior of chondrocytes on NSF were examined. The plasma treatment resulted in an increase in the hydrophilicity of NSF meshes suggesting that the cytocompatibility of the mesh might be improved. Furthermore, the human articular chondrocytes showed higher viability on the surface-modified NSF meshes. These results suggest that the surface modification of NSF meshes by plasma can enhance the cellular behavior of chondrocytes and may be used in tissue engineering.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.286-292
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• 1995

Buerger's disease(Thromboangiitis Obliterans) is characterized by peripheral arterial occlusion of the extremities in young smokers, and leading to ischemia of the tissue and gangrene. Most of these patients suffered from severe pain. therapy for Buerger's disease not enable to undergo reconstructive arterial surgery has been discouraging while multiple modes of analgesics have advanced. Eight subjects who had been operated due to Buerger's disease or diagnosed with this disease were evaluated retrospectively. Continuous epidural block was done at L 2~3 or L3~4 intervertebral space and multiday continuous infusor was connected to epidural catheter. The content of the infusor was clonidine-bupivacaine or clonidine-morphine-bupivacaine mixture. The minimum dose of clonidine was 75 ${\mu}g/day$ and the maximum 450 ${\mu}g/day$. The results were as follows: The analgesia produced by clonidine was superior to any other analgesics. 2) The incidence of the side effects produced by clonidine-bupivacaine mixture were less than that of clonidine-morphine-bupivacaine mixture. 3) Minimum dose of clonidine for the pain relief was required more than 225 ${\mu}g$ per day. From the above results, we recommend that clonidine is an effective agent to provide pain relief for the patients with Buerger's disease.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.17-25
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• 2017

Background: The purpose of this study was to investigate how the resistive exercises with vibration stimuli could affect the strength of knee muscles and balance in patients with a history of reconstructive surgery. Methods: Thirty four subjects with anterior cruciate ligament reconstruction were randomly divided into 3 groups; Resistive exercises with vibration stimuli group (n=11), Resistive exercises (n=11) and control group (n=12). The paired t-test was used to show the variation before and after exercise in all three groups. One way ANOVA was used to separate the total variation between groups. Results: The results showed that there was significant improve in the strength of knee muscles in all three groups and resistive exercise with vibration stimuli he group showed a better result in all area than the other two groups. Comparisons of sway distances with open and closed eyes showed a statistically significant decrease before and after treatment in all three groups, there was no statistically significant difference between groups. There was a significant difference only in the sway distance with the eyes closed. Conclusions: Applying the resistive exercise with vibration stimuli as a therapeutic exercise program resulted in a positive effect to the functional activity not only in rapidly recovering the strength the weaken muscles and lost of balance ability, but also expecting an earlier return to daily life by advancing the date of the process for the functional activity.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.3-14
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• 1983

In recent years there has been considerable interest in reconstructive surgery of the trachea for cervical tracheal stenosis developed by complication of endotracheal intubation or tracheotomy, or trauma of the neck. The methods used to reconstruct the tracheal defects can be repaired with end-to - end anastomosis, cervical flaps, and autogenous graft materials. Since Grillo had undertaken tracheal reconstruction after circumferential resection in dogs, resection and end - to - end anastomosis was used in cases of circumferential stenosis. And, costal, nasal septal and auricular cartilage have been used for the autogenous graft materials. Since Caputo and Consiglio had undergone tracheoplasty with auricular cartilage, Morgenstein reported successful repair of a tracheal defect with a composite postauricular cartilage graft. The advantages of the auricular cartilage graft are its easy accessibility, availability and familiarity to the otolaryngologist. In past 2 years, We performed the tracheoplasty with auricular cartilage graft and end- to end an astomosis after segmental resection in 5 patients who had suffered from tracheal stenosis. And we obtained good results. So, we reported the cases with review of the literatures.

• Archives of Pharmacal Research
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• v.28 no.7
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• pp.784-790
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• 2005

In this study, we evaluate the effects of (-)-epigallocatechin-3-gallate (EGCG) on ultraviolet B(UVB)-irradiated living skin equivalents (LSEs). Histologically, UVB irradiation induced thinning of the LSE epidermis, whereas EGCG treatment led to thickening of the epidermis. Moreover, EGCG treatment protected LSEs against damage and breakdown caused by UVB exposure. Immunohistochemically, UVB-exposed LSEs expressed p53, Fas, and 8-hydroxy-deoxyguanosine (8-OHdG), all of which are associated with apoptosis. However, EGCG treatment reduced the levels of UVB-induced apoptotic markers in the LSEs. In order to determine the signaling pathways induced by UVB, Western blot analysis was performed for both c-Jun $NH_2$-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK), which are associated with UVB-induced oxidative stress. UVB activated JNK in the epidermis and dermis of the LSEs, and EGCG treatment reduced the UVB-induced phosphorylation of JNK. In addition, p38 MAPK was also found to have increased in the UVB-exposed LSEs. Also, EGCG reduced levels of the phosphorylation of UVB-induced p38 MAPK. In conclusion, pretreatment with EGCG protects against UVB irradiation via the suppression of JNK and p38 MAPK activation. Our results suggest that EGCG may be useful in the prevention of UVB-induced human skin damage, and LSEs may constitute a potential substitute for animal and human studies.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.474-479
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• 2010

Torsades de pointes associated with a prolonged QT interval is a life-threatening arrhythmia, which may be induced by any of the following: drugs, electrolyte imbalances, severe bradycardia and intracranial hemorrhage. Torsades de pointes is characterized by beat-to-beat variations in the QRS complexes in any ECG leads with rates of 200~250 per minute. Fluoroquinolones are widely used and well tolerated antibacterial agents. However, prolongation of the QT interval leads rarely to Torsades de pointes as a significant adverse effect. So, it should be used with caution in high-risk patients for developing Torsades de pointes. We report one case of 67-year old man with contact burns who experienced Torsades de pointes, which probably resulted from the use of levofloxacin, and no further episode occurred after its withdrawal.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.237-242
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• 2007

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques. Methods: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4 cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull-out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7 mm incision. For the parenchymal diameter more than 4 cm, ultrasound-assisted liposuction and excision were applied through 2.5 cm periareolar approach. Results: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars. Conclusion: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.654-659
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• 2009

Purpose: A botulinum toxin type A (BoNT - A) injection has been used as a noninvasive management for lower face contouring since 2000. The aim of this study was to compare reduction rate of lower face width for a longtime according to repeated Botox$^{(R)}$ injections on masseter muscles for lower face contouring procedure. Methods: Forty - five patients were analyzed for single session of Botox$^{(R)}$ injection and 13 patients were evaluated for repeated Botox$^{(R)}$ injections for over two years. Single injection group was tracked regular intervals at 1, 3, 6, 10, 12 months after injection, and repeated injection group was measured at every injection time. Twenty - five to thirty units of Botox$^{(R)}$ was injected into each masseteric muscle at five to six points at the prominent portions of the mandibular angle. Standardized frontal view of digital photographs were analyzed by Adobe Photoshop$^{(R)}$ (version CS3) to measure an reduction rate of lower face width. Results: Reduction rate was 3.7%, 6.9%, 6.2%, 4%, 4% at 1, 3, 6, 10, 12 months post injection each other in single injection group. However, more than 8% reduction rate was found in repeated injection group persistently for more than two years. Conclusion: This study shows that effective duration of Botox$^{(R)}$ injection for lower face contouring is expected to continue over one year clinically. Moreover, repeated injections maintained lower reduction rate consistently for a long time. Therefore, repeated injections on masseter muscles at regular intervals are most effective procedure for lower face contouring.