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Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

  • Prasetyono, Theddeus O.H.;Koswara, Astrid Felicia
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.164-172
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    • 2015
  • Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

A Case of Trigger Finger Following Longitudinal Tear of Flexor Digitorum Superficialis after Repeated Closed Injury (반복적인 얕은손가락굽힘근힘줄 폐쇄성 손상 후 발생한 방아쇠 손가락 증례)

  • Choi, Hwan-Jun;Choi, Eui-Chul;Kim, Yong-Bae
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.304-308
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    • 2010
  • Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.

A Determining System for the Category of Need in Long-Term Care Insurance System using Decision Tree Model (의사결정나무기법을 이용한 노인장기요양보험 등급결정모형 개발)

  • Han, Eun-Jeong;Kwak, Min-Jeong;Kan, Im-Oak
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.145-159
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    • 2011
  • National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

Analysis of Relationship between 2-D Fabric Tensor Parameters and Hydraulic Properties of Fractured Rock Mass (절리성 암반의 이차원 균열텐서 파라미터와 수리적 특성 간의 상관성 분석에 관한 연구)

  • Um, Jeong-Gi;Han, Jisu
    • Tunnel and Underground Space
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    • v.27 no.2
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    • pp.100-108
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    • 2017
  • As a measure of the combined effect of fracture geometry, the fabric tensor parameters could quantify the status of the connected fluid flow paths in discrete fracture network (DFN). The correlation analysis between fabric tensor parameters and hydraulic properties of the 2-D DFN was performed in this study. It is found that there exists a strong nonlinear relationship between the directional conductivity and the fabric tensor component estimated in the direction normal to the direction of hydraulic conductivity. The circular radial plots without significant variation of the first invariant ($F_0$) of fabric tensor for different sized 2-D DFN block are a necessary condition for treating representative element volume (REV) of a fractured rock mass. The relative error (ER) between the numerically calculated directional hydraulic conductivity and the theoretical directional hydraulic conductivity decreases with the increase in $F_0$. A strong functional relation seems to exist between the $F_0$ and the average block hydraulic conductivity.

Optimization of Ingredient Mixing Ratio for Preparation of Sponge Cake with Bamboo (Pseudosasa japonica Makino) Leaves Powder (대나무잎 가루를 첨가한 스펀지 케이크 재료 혼합비율의 최적화)

  • Park, Jung-Eun;Jeong, Heung-Do;Jang, Myung-Sook
    • Korean journal of food and cookery science
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    • v.25 no.3
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    • pp.317-329
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    • 2009
  • In the study, we determined the optimal ingredient mixing ratio for the preparation of sponge cake containing bamboo (Pseudosasa japonica Makino) leaves. This experiment was designed in according with the D-optimal design of mixture design, which involved 14 experimental points including 4 replicates for three independent variables (sugar 110${\sim}$129%, bamboo leaves 3${\sim}$8%, oil 10${\sim}$25%). The results the F-test, specific gravity, volume and color values (L, a, b) decided a linear model, while the viscosity, hardness and sensory characteristics (color, smell, taste, texture and overall acceptance) decided a quadratic model. The results of our fitness analysis demonstrated that in all characteristic, the probabilities were significant within 0.05%; thus, the models were accepted as appropriate. The response surface and trace plot results demonstrated that increasing amounts of added bamboo leaves induced a reduction in brightness, and increasing redness and yellowness. In addition, increasing amounts of bamboo leaves caused increases in hardness, and thus the softness of the cake decreased. And as the level of added oil increased, softness increased. Cake samples received low sensory evaluation scores when sugar, bamboo leaves, and oil were added above their optimal levels. In the numeric optimization, the optimal ingredient amounts were 121.36% sugar, 4.96% bamboo leaves, and 15.69% oil. The above results demonstrate the feasibility of adding bamboo leaves to sponge cake, and therefore, a bamboo leaves as a functional food.

Antigastritic and Antiulcerative Effect of Pulmuone Healthy Aloe Gel (생약복합제 Pulmuone Healthy Aloe Gel의 위장질환 개선 효과)

  • Kang MinHee;Cho SoYean;Kim HyunSu;Kim DongHyun;Jeong ChoonSik
    • YAKHAK HOEJI
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    • v.49 no.3
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    • pp.237-243
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    • 2005
  • Present study was performed for the development of a new supplementary product with gastroprotective effect. The preliminary screening were conducted for the effects of HCl-ethanol-induced gastric lesions in rats. Samples were aloe gel, active hexose correlated compound (AHCC) mentioned that have GI protective property and pulmuone healthy aloe gel (PHAG) that mixture of natural products from Pulmuone company. Aloe gel significantly inhibited HCl-ethanol-induced gastric lesions at the oral dose of 5 ml/kg. AHCC showed the strongest effectiveness at the oral dose of 1,200 mg/kg. PHAG also showed the significant effects at the oral dose of 10, 20 g/kg. In pylorus ligated rats, the treatments of aloe gel, AHCC and PHAG showed decrease in the volume of gastric secretion and acid output. And aloe gel, AHCC and PHAG significantly suppressed the aspirin-induced ulcer and chronic ulcer in pylorus ligated rats. The treatments of aloe gel and PHAG significantly reduced acetic acid-induced ulcer at the oral dose of 5 ml/kg and 10 g/kg for 12 days. In this study; we have found that PHAG had significant improvement in acute gastritis and ulcer at the dose of 20 g/kg and in chronic gastritis and ulcer at the dose of 10 g/kg. Also we evaluated the anti-bacterial activity against H. pylori treated with aloe gel, AHCC and PHAG. PHAG had a equivalent anti bacterial activity with ampicillin against H. pylori at the dose of 1 g/kg.

Effects of Peanut Sprout Extract and Powder on Quality Characteristics and Antioxidant Activity of Wet Noodles (새싹땅콩 분말 및 추출물이 생면 품질특성과 항산화 활성에 미치는 영향)

  • Kim, Min-Ji;Lee, Soo-Jeong
    • The Korean Journal of Food And Nutrition
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    • v.28 no.3
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    • pp.507-516
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    • 2015
  • This study investigated the quality characteristics and antioxidant activities of wet noodles as well as their cooking properties following the addition of peanut sprout extract (PSE) and powder (PSP), which are known to contain a significant level of resveratrol. Wet noodles were prepared with 0, 2.5, 5, 7.5 and 10% PSE and PSP. Quality characteristics such as increasing volume of noodle, water ratio, turbidity of cooking water and color, texture, and sensory evaluation were then assessed. Additionally, the total resveratrol content in the cooked noodles was analyzed by HPLC and DPPH free radical scavenging capacity. As the amount of PSE and PSP increased, the L value of wet and cooked noodles significantly decreased, whereas the a and b values increased (p<0.001). The L value of cooked noodles was significantly lower compared to wet noodles (p<0.001) whereas the a and b values were higher. For the cutting intensity properties of the cooked noodles, hardness was reduced with increasing amounts of PSE (p<0.001), and was significantly increased in proportion to the amount of PSP (p<0.05). Meanwhile, springiness was not significantly different in all groups. Total resveratrol content and free radical scavenging activity significantly increased in proportion to the amounts of PSE and PSP (p<0.001), especially in noodles containing 5%, 7.5% and 10% PSE and PSP. Finally, sensory evaluation of PSE noodle revealed that color, flavour, taste were significantly decreased (p<0.05). But there was no difference in overall acceptance among cooked noodles with 2.5% to 5% PSE comparison to the control. Sensory characteristics in the PSP noodle showed similar results. In conclusion, these findings suggest that peanut sprout extract and powder could be potentially used as functional food ingredients. In addition, up to 5% PSE and PSP can be substituted for wheat flour.

Electrochemical Performance of Activated Carbon Electrode Materials with Various Post Treatments for EDLC (활성탄의 후 처리에 의한 EDLC 전극재의 전기화학 성능 개선)

  • Lee, Eunji;Kwon, Soon Hyung;Choi, Pooreum;Jung, Ji Chul;Kim, Myung-Soo
    • Korean Journal of Materials Research
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    • v.24 no.6
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    • pp.285-292
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    • 2014
  • Commercial activated-carbon used as the electrode material of an electric double-layer capacitor (EDLC) was posttreated with various acids and alkalis to increase its capacitance. The carbon samples prepared were then heat-treated in order to control the amount of acidic functional groups formed by the acid treatments. Coin-type EDLC cells with two symmetric carbon electrodes were assembled using the prepared carbon materials and an organic electrolyte. The electrochemical performance of the EDLC was measured by galvanostatic charge-discharge, cyclic voltammetry, and electrochemical impedance spectroscopy. Among the various activated carbons, the carbon electrodes (CSsb800) prepared by the treatments of coconutshell-based carbon activated with NaOH and $H_3BO_5$, and then heat treated at $800^{\circ}C$ under a flow of nitrogen gas, showed relatively good electrochemical performance. Although the specific-surface-area of the carbon-electrode material ($1,096m^2/g$) was less than that of pristine activated-carbon ($1,122m^2/g$), the meso-pore volume increased after the combined chemical and heat treatments. The specific capacitance of the EDLC increased from 59.6 to 74.8 F/g (26%) after those post treatments. The equivalent series resistance of EDLC using CSsb800 as electrode was much lower than that of EDLC using pristine activated carbon. Therefore, CSsb800 exhibited superior electrochemical performance at high scan rates due to its low internal resistance.

A Study on the Expressional characteristics of Geometrical Design in the Deconstructive and Experimental Architects (해체 및 실험적 건축가들의 기하학적 디자인 표현 특성에 관한 연구)

  • 황태주
    • Korean Institute of Interior Design Journal
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    • no.11
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    • pp.57-63
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    • 1997
  • In the early 20'c, scientific thoughts make a change the absolute and separate concept of space-time into relative concept of continual entity; a kind of ideal world. It suggests that the meaning of geometry as absolute truth with which has endowed human beings would changed to a relative meaning of accumulation in intellectual work on 'nature'. This cognitive changes appeared into absolute arts in 20'c like Cubism, Superematism or Constructivism. De Stijl movement which had recepted the relative concepts like Einstein's 'theory of relativity' as a developed thought from Newton-Cartesian cognition on the world. Abstration would be adequate method for expressing the dynamics and interrelationship between forms and for giving values to indivisual elements in a compositiov. This method had appeared Modern architectural form, as a common framework. The expression characteristics of geometrical design in Deconstructive and Experimental architecture were summerized in four features through the results of the analysis. First, the relation of architectural element and intertextuality is expressed in discontinuation of context and refusal of functional building. Second, the concept of trace expresses as connection of place, decomposing of excavation of trace, trace of axis, trace of fragments. Third, anti-gravity expression is there to express of open cubic, to outgrow of rectangular system, to outgrow of volume, to separate of ground connectiov. Fourth, the complex composition of abstracted geometric form is these to abstracted geometry about indefinite shape, to layer through the overlap and collage, to de-meaning and amusement of form through the pursuit of uncertainty, to indeterminate of formal meaning through operation and composition of similar form cause to the diverse of meaning.

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Milk Fat Globule-Epidermal Growth Factor VIII Ameliorates Brain Injury in the Subacute Phase of Cerebral Ischemia in an Animal Model

  • Choi, Jong-Il;Kang, Ho-Young;Han, Choongseong;Woo, Dong-Hun;Kim, Jong-Hoon;Park, Dong-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.163-170
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    • 2020
  • Objective : Milk fat globule-epidermal growth factor VIII (MFG-E8) may play a key role in inflammatory responses and has the potential to function as a neuroprotective agent for ameliorating brain injury in cerebral infarction. This study aimed to determine the role of MFG-E8 in brain injury in the subacute phase of cerebral ischemia in a rat model. Methods : Focal cerebral ischemia was induced in rats by occluding the middle cerebral artery with the modified intraluminal filament technique. Twenty-four hours after ischemia induction, rats were randomly assigned to two groups and treated with either recombinant human MFG-E8 or saline. Functional outcomes were assessed using the modified Neurological Severity Score (mNSS), and infarct volumes were evaluated using histology. Anti-inflammation, angiogenesis, and neurogenesis were assessed using immunohistochemistry with antibodies against ionized calcium-binding adapter molecule 1 (Iba-1), rat endothelial cell antigen-1 (RECA-1), and bromodeoxyuridine (BrdU)/doublecortin (DCX), respectively. Results : Our results showed that intravenous MFG-E8 treatment did not reduce the infarct volume; however, the mNSS test revealed that neurobehavioral deficits were significantly improved in the MFG-E8-treated group than in the vehicle group. Immunofluorescence staining revealed a significantly lower number of Iba-1-positive cells and higher number of RECA-1 in the periinfarcted brain region, and significantly higher numbers of BrdU- and DCX-positive cells in the subventricular zone in the MFG-E8-treated group than in the vehicle group. Conclusion : Our findings suggest that MFG-E8 improves neurological function by suppressing inflammation and enhancing angiogenesis and neuronal proliferation in the subacute phase of cerebral infarction.