• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.29-35
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• 2002

Free flap reconstruction of the foot has become one of the standard procedures at the present time, but choice of a free flap for the soft tissue defect of the foot according to location and size remains controversial. We evaluated the results of free flap reconstruction for the soft tissue defects of the foot. Twenty seven free flaps to the foot were performed between May 1986 and December 2000 in the department of Orthopedic Surgery. Patient age ranged from 3 to 60 years. Male to female distribution was 20:7. Mean follow-up period was 30.5 months which ranged from 12 months to 60 months. The indications for a specific flap depended on the location and extension of the foot defect. In weight-bearing area and amputation stump, the authors chose the sensate (reinnervated) dorsalis pedis flaps (n=7) and sensate radial forearm flaps (n=2). In nonweight-bearing area including dorsum of the foot and area around Achilles tendon, we performed nonsensate (non-reinnervated) free flap reconstructions which included dorsalis pedis flaps (n=5), groin flap (n=1), radial forearm flaps (n=6), scapular flaps (n=4), latissimus dorsi flaps (n=2). Twenty-six flaps transferred successfully (96.3%). The sensate flaps which were performed in weight-bearing area and amputation stumps survived in all cases and recovered protective sensation. Mean two-point discrimination was 26 mm at the last follow up. As a conclusion, the selection of a proper flap depends on the location and extension of the foot defect and patient's age. Fasciocutaneous flap including radial forearm flaps and dorsalis pedis flaps were the best choice in nonweight-bearing area. The sensate free flaps which are performed in the weight-bearing area and amputation stumps can produce better outcome than nonsensate free flap.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.114-119
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• 2000

The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.120-126
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• 2000

Microsurgical reconstruction of the hand demands recovery of the sensation of the reconstructed free flap as well as microsurgeon's intelligence, technique and experience. Even with adequate soft tissue coverage and skeletal mobility, an insensate hand is prone to further injury and is unlikely to be useful to the patients. Authors have performed 8 cases of neurosensory free flaps in the hand, 4 cases of wrap around, 3 dorsalis pedis and 1 lateral arm flap, from July 1992 through June 1999 and followed up average 4 years and 4 months. Wrap around flap was performed for reconstruction of 4 cases of thumb, repairing deep peroneal nerve and superficial radial nerve by epineurial neurorrhaphy, and followed up for average 3 years and 10 months and calculated 9mm in the static 2 point discrimination test. Dorsalis pedis flap were 3 cases for reconstruction of the ray amputation, extensor tendon exposure and wrist exposure. Deep peroneal nerve and branch of the ulnar nerve was repaired by epineurial neurorrhaphy calculating 6mm and superficial peroneal nerve and superficial radial nerve averaging 18mm in the static 2 point discrimination test for follow up average 2 years and 9 months. Lateral arm flap was 1 case for reconstruction of the ray amputation in the hand repairing posterior cutaneous nerve to the arm to the superficial radial nerve calculating 20mm for follow up 6 years and 8 months.

• The Journal of Internal Korean Medicine
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• v.27 no.1
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• pp.288-293
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• 2006

Background : Monoplegia is the paralysis of a limb. It is commonly caused by an injury to the cerebral cortex, and rarely caused by injury to the internal capsule, brain stem, or spinal cord. Most problems with cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. Objectives : This study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment of monoplegia on an upper extremity to test the validity of acupuncture and herbal treatment for it. Methods : By using Digital Infrared Thermographic Imaging(DITI), thermal differences$({\Delta}T)$ of acupoints on the upper extremity in a patient with monoplegia on the right upper extremity were measured after an attack of the disease. By giving Mangeum-tang(萬金湯) and treating the patient with acupuncture. the temperature changes of the upper extremity were examined through DITI and improvement was observed. Results : Compared with the left arm which suffered no such injury, the right recovered about 80% of sensation, and the grade of monoplegia improved from Grade O to Grade V. Also, the temperatures of right palmar-dorsal hand and the region of Weiguan(外關, Waiguan, TE5) were $1^{\circ}C$ and $1.45^{\circ}C$ higher than the same left region on admission day, but the thermal differences$({\Delta}T)$ narrowed to $0.5^{\circ}C$ by the last day. Conclusions : Results suggest that DITI screening is a reliable method of prognosis and that the time required for treatment can be estimated through this method in cases of monoplegia to an upper extremity. Also, progress in treatment is reflected in thermal differences of acupoints of the monoplegic upper extremity in accordance with the theory of meridian. This supports a role for acupuncture and herbal treatment for monoplegia.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.233-238
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• 2010

Purpose: As the use of soft tissue fillers becomes more popular, complications such as foreign body granuloma (FBG) are increasing. We report 120 cases of facial FBG and review the available literatures. Methods: 120 patients of facial FBG in our clinic from Mar. 2003 to Feb. 2008 were complied and analyzed. A retrospective chart review was done and patient satisfaction was evaluated with a questionnaire using 5 score scale. Patients with severe inflammation sign or bizarre deformity underwent surgical excision and those with minimal symptoms or a history of hyaluronic acid injection received injection therapy using hyaluronidase. Results: 100 females and 20 males were observed. The average age was 43.7 years (from 16 to 74). 84 patients received surgical therapy and 36, injection therapy. Deformity of facial contour, foreign body sensation and inflammation sign were the three main chief complaints. 84 patients did not know what the injection materials were. The known materials are as follows: collagen, hyaluronic acid, silicone oil, paraffin. 92 cases were performed by unlicensed practitioners, 29 by physicians. Anatomical site most frequently affected by the foreign body granuloma was the cheek (25.8%), followed by forehead (19.2%), lips (15.8%), nose (9.2%), mentum (8.3%), eyelid and eyebrow (4.3%) and temple (0.8%). In 21 patients (17.5%), FBGs were found on multiple sites. Patients with inflammation sign got the highest satisfaction ($3.19{\pm}0.73$) (p=0.001) among 3 chief complaints. And patient satisfaction was statistically higher in surgical therapy group ($3.43{\pm}0.72$) than in injection therapy group ($2.97{\pm}0.88$) (p=0.003). Conclusion: We suggest that it may be beneficial to tailor the type of treatment for FBG relying on wound state and patient's chief complaints. In surgical therapy, resolute approach is necessary to correct facial deformity definitely and to minimize inflammation. Injection therapy could be another option for those with minimal symptoms or a history of hyaluronic acid injection. To prevent foreign body granuloma, not only plastic surgeons but also other physicians should inject soft tissue fillers with great caution and we should warn the public of disastrous consequences associated with illegal medical practice.

• The Korean Journal of Mycology
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• v.9 no.4
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• pp.199-207
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• 1981

This investigation was undertaken to establish more accurately the clinical features of the desease as seen in Korea, and to investigate susceptibility factors and to study the ecology of P. orbiculare in this condition. All of 50 new patients with Tinea versicolor attending the Ewha University Hospital, during a period of 6 months were studied personally. 1. Clinical feature: The sex ratio of the whole series was 32 males to 18 females. Twenty of 50 patients (40%) were between the age of 20 to 29 years. The duration of disease was more than 4 months in 37 of 50 patients (74%). The cases of first onset in June, July and August were 33 of 50 patients (66%). Whereas, the developed in December, January and February were only 3 of 50 patients (6%). Seasonal fluctuation was remarkable in 16 of 25 patients (66.7%) who had the duration of more than 1 year. The course of disease was rapid in 33 of 50 patients (66%) and slow in 9 of 50 patients (18%). Thirty-three of 50 patients (66%) had not any subjective symptoms. Thirteen patients (26%) had mild itching sensation and 4 patients (8%) had severe itching. The frequency of the first affected were neck (27.4%), axilla (19.2%) anterior chest (15.0%) and groin (11.0%). 7) Hyperpigmented lesions were observed in 35 of 50 patients (70%) and hypopigmented lesions were observed in 11 of 50 patients (22%). Skin lesions were noticed mainly in the anterior chest, neck, back and axilla, and more severe in the anterior chest, back and abdomen than other areas. Tinea versicolor was particularly prevalent in those persons who had occupations of mental work and who perspired every day or every 2 or 3 days. A positive family history of Tinea versicolor was obtained in 7 of 50 patients (14%). Fourteen of 50 patients (28%) had association with superficial fungal infections. 2. Mycological features: Typical appearance of M. furfur was observed in all scrapings from 25 lesions and only 3 scrapings from 20 clinically skin of the patients. P. orbiculare was seen on direct examination of scrapings from 24 of 25 skin lesions, from 19 of 20. clinically normal skin of patients and from 18 of 29 control normal skin. The quantity of P. orbiculare was greater in skin lesions and clinically normal skin area than in control normal skin surfaces.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.392-399
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• 1992

Background: Despite dyspnea is a predominant complaint of patients with respiratory disease, the mechanisms contributing to the sensation of breathlessness are poorly understood. Traditionally, physicians have measured objective pulmonary function to assess severity of dyspnea. But it will be also useful to measure subjective dyspnea index because dyspnea probably depends on a complex interplay of mechanical, experimental, emotional and other factors. Method: We measured breathlessness at rest, after Methacholine challenge and then bronchodilator inhalation using a Visual Analogue Scale (VAS) and Borg Scale Dyspnea Index (BSDI) in stable asthmatic patients. Spirometry was performed concomittently. Results: There was no correlation between dyspnea index and FEV1. There was also no correlation between the change in dyspnea index and change in FEV1. The change in dyspnea index after methacholine and bronchodilator was greater in clinically mild asthmatic patients than clinically severe symptomatic group. Conclusion: In asthmatic patients, there was a wide variation in sensory response for any given FEV1, and the change in perception of dyspnea was greater in those with clinically mild symptoms. The measurement of dyspnea index may yield information complementary to that obtained by spirometry.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.35-45
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• 2010

Backgrounds : Recently, commercial indirect moxibustion has been widely used as a substitute for traditional indirect moxibustion by clinicians due to its convenience in using. But, there has been lack of studies about the similarity of thermal stimulation between commercial indirect moxibustion and traditional indirect moxibustion. Objectives : To demonstrate commercial indirect moxibustion can substitute for traditional indirect moxibustion by comparing thermal stimulation between the two. Methods : We measured bottom temperature of commercial indirect moxibustion and traditional indirect moxibustion with various thicknesses of ginger and garlic. A clinical trial was performed on 18 healthy subjects to evaluate thermal stimualtion. The subjects were randomly assigned into two groups, traditional indirect moxibustion with ginger and garlic. The skin temperature and heating time were measured. They received moxibustion therapy with commercial indirect moxibustion and traditional indirect moxibustion according to their groups. Acupoint Chogcoe($LU_6$), Zusanli($ST_{36}$) and Tianshu($ST_{25}$) were used in each group for 3 times. Results : There was no difference in bottom temperature among commercial indirect moxibustion, traditional indirect moxibustion with 2mm ginger and 3mm garlic. No major difference was detected in the subjects' baseline data. There was no difference in skin temperature and heating time among these 3 type of moxibustions. Also, No major difference was detected in VAS score of thermal stimulation and frequency of burns among these 3 type of moxibustions. But, most subjects regarded their sensation weren't identical because of its own distinct characteristics. Conclusions : Commercial indirect moxibustion, traditional indirect moxibustion with 2mm ginger and 3mm garlic have same thermal stimulation. Thus, commercial indirect moxibustion can substitute for traditional indirect moxibustion.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.11
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• pp.1705-1709
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• 2010

Peppers (Capsicum annuum L.) are a rich source of phytochemicals including polyphenolics, flavonoids, capsaicinoids and ascorbic acid. Capsaicinoids are a group of 12 or more related alkaloids responsible for the pungent sensation in the fruits of the genus Capsicum. Ascorbic acid is another functional and nutritional constituent of peppers. In this study, the contents of two major capsaicinoids (capsaicin and dihydrocapsaicin) and ascorbic acid in 131 pepper breeding lines were quantified by HPLC. In 131 pepper breeding lines, capsaicin and dihydrocapsaicin contents were in the range of 0.0 to 219.6 and 0.0 to 110.8 mg/100 g, respectively. The breeding lines with higher capsaicin content contained higher dihydrocapsaicin content as well. Ascorbic acid contents were 264.9 to 1695.5 mg/100 g for the 131 pepper breeding lines. The analytical method validation parameters including accuracy, repeatability, and reproducibility were calculated to ensure the method's validity. This study provides basic information to plant breeders and biotechnologists who are planning to breed genotypes with high content of phytochemicals.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.53-58
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• 2007

Background and Purpose : The purpose of this study was to investigate that which symptoms are adequate indicator of the Dampness-Phlegm pattern in the stroke patients. Methods : In the time period Jul. 2005 to Sep. 2006, 136 patients with a first-ever stroke admitted in the department of Internal Medicine of Daejeon University Oriental Medical Hospital in Daejeon city, Wonkwang Oriental Medical Hospital in Iksan, JeonJu city were included. Patients were hospitalized within 3 months after the onset of stroke. Stroke patients had been interviewed by resident who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. Gi-deficiency patients was confirmed by medical specialist diagnosis, resident diagnosis, case report form analysis without a dissenting voice. Results : Dampness-Phlegm group included 37 case, Non Dampness-Phlegm group 45 case out of 136 patients. white tongue coating, slippery purse, yellowish complexion, enlarged tongue, swollen tongue were higher among Dampness-Phlegm group. Dampness-Phlegm and Non Dampness-Phlegm patients do not significantly differ in heavy sensation in the head, voice with sputum, teeth printed tongue, borborygmus, dizziness with nausea. Conclusions : This study was insufficiency because sample size is very small. More data from prospective cohort studies will help to Korean Standard Differentiation of the Symptoms and Signs for the Stroke.