PURPOSE: To find the factors influencing the immediate and late outcome of replantation and revascularization of the digits, we carried out a prospective study from 1998 to 1999 with at least a 1-year followup. Traumatic total and subtotal amputations with inadequate circulation of the digits distal to the metacarpal head were included in the study. METHODS: This study was carried out as a prospective study from 1998 to 1999 with at least a 1- year followup. The relationship between age, sex, extent of injury, type of injury, ischemic time, regular smoking, level of injury, and survival rate were analyzed. There were 234 patients with 155 males (254 digits) and 79 females (129 digits). RESULTS: Successful operation was found in 203 patients (86.3%), 314 digits (82%). Although male patients seemed to have poorer survival rates than female, it should be noted that male patients had more severe injuries than female patients. All patients who were regular cigarette smokers were males. Cigarette smoking has been shown to cause cutaneous vasoconstriction, decrease the digital blood flow, and impair the wound healing. These two reasons might explain the lower survival rate in males than in females. Type of injury significantly affected the survival rate. The survival rate was very low in extensive crushed amputation (11.1% survival rate), followed by degloving (21.1% survival rate) and avulsion (64.7% survival rate) amputation. The level of injury also seemed to determine the survival rate as injury at Zone I (65% survival rate) resulted in a poor survival rate compared to the injury at Zone II, III, or IV (92%, 97.6%, or 90.9% survival rate). Ischemic time longer than 8 hours might lessen the survival rate. CONCLUSION: All patients who had successful replantation and revascularization were satisfied with the results even though they had rather poor hand movement. In single digital replantation, no patients needed reamputation, but all preferred to have their finger replanted than udergo a primary amputation. All could accommodate and adapt their injured digits to their work.
Amputation ; Female ; Fingers ; Follow-Up Studies ; Hand ; Head ; Humans ; Male ; Prospective Studies ; Replantation* ; Smoke ; Smoking ; Survival Rate ; Tobacco Products ; Vasoconstriction ; Wound Healing

Since the initial description of allergic fungal sinusitis by Millar et al. in 1981, reported cases have been increasing. However, one case of allergic fungal sinusitis has been reported in Korea. The diagnosis can be established by demonstrating type I hypersensitivity reaction, nasal polyposis, characteristic CT scan, eosinophilic mucus without evidence of fungal invasion into sinus tissue, and a positive fungal stain or culture of sinus contents. The authors present a case which met the diagnostic criteria of allergic fungal sinusitis. This patient had nasal polyp and showed elevated level of total IgE, peripheral eosinophilia, positive MAST and strongly positive immediate skin reactivity to fungal antigens. On histologic examination, typical allergic mucin containing sheets of eosinophils, Charcot-Leyden crystals was found. Fungal hyphae were also found in the mucin content.
Antigens, Fungal ; Diagnosis ; Eosinophilia ; Eosinophils ; Humans ; Hypersensitivity, Immediate ; Hyphae ; Immunoglobulin E ; Korea ; Mucins ; Mucus ; Nasal Polyps ; Sinusitis* ; Skin ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Exposure to noise results in pertubations of cochlear microcirculation. There is evidence that these events are mediated, in part, by the calcium channel. The subsequent decrease in cochlear blood flow may lead to hypoxia and predispose to the formation of free oxygen radicals. Saponin extracted from Korean red ginseng is generally known to enhance blood flow and scavenge for free oxygen radicals. MATERIALS AND METHODS: We investigated the effect of saponin (100 mg/kg) on the cochlear damage induced by noise exposure (1500 Hz narrow band noise, 115 dB, 12hours) in guinea pigs through auditory brainstem response (ABR) and with scanning electron microscopy (SEM), RESULTS: After noise exposure, the saponin pre-treated group showed a significant decrease in the ARR threshold compared with the saponin non- treated group. Also, SEM findings of the cochlea showed that there was a minimal structural change in the outer hair cells in the saponin pre-treated group. CONCLUSION: Saponin extracted from Korean red ginseng can attenuate noise induced cochlear damage in guinea pigs.
Animals ; Anoxia ; Calcium Channels ; Cochlea ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs ; Hair ; Hearing Loss ; Microcirculation ; Microscopy ; Microscopy, Electron, Scanning ; Noise* ; Panax* ; Reactive Oxygen Species ; Saponins*

BACKGROUND AND OBJECTIVES: Large doses or long-term use of salicylate may cause reversible tinnitus and hearing loss. The exact cause of salicylate ototoxicity in unknown. Decreased cochlear blood flow following reversible biochemical changes in the cochlea seems to play an important role in salicylate ototoxicity. Protopanaxatriol and protopanaxadiol saponin of the Panax ginseng are known to have a vasodilatory effect. We investigated the effect of Panax ginseng saponin on salicylate induced hearing loss in guinea pigs. MATERIALS AND METHODS: Guinea pigs were divided into two groups. The control group was injected with salicylate (300 mg/kg, IM) and the experimental group was pretreated with Panax ginseng saponin (100 mg/kg, IP) before salicylate injection. ABR threshold was measured hourly after salicylate injection. RESULTS: The control group showed a maximal hearing loss (20+/-3.54 dBnHL) in 3 hours after the salicylate injection. Comparing with the control group, the experimental group revealed a significantly different maximal hearing loss (5+/-3.54 dBnHL). CONCLUSION: These results suggest that the protopanaxatriol and protopanaxadiol saponin of the Panax ginseng can attenuate salicylate induced hearing loss.
Animals ; Cochlea ; Guinea Pigs* ; Guinea* ; Hearing Loss ; Panax* ; Saponins* ; Tinnitus

Bony Callus ; Humans ; Mandible ; Osteoblasts ; Osteogenesis ; Osteotomy