• Archives of Plastic Surgery
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• 제42권4호
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• pp.446-452
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• 2015

Background Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon. Methods Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole. Results The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously. Conclusions This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.

• 대한간호학회지
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• 제19권2호
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• pp.147-159
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• 1989

The main Purpose of this survey was to identify for elements of an effective hospital infection control program for Korea. Nurses and doctors who had participated in an education program for infection control or were re s ponsible for hospital infection control were selected as data informers. The data were collected from 51 subjects by employing a Delphi technique in a series of three rounds from september 1, 1987, to March 31, 1988. IN each round the responses to questionaires were analyzed and the results were communicated back to the individuals. Finally 32 elements of effective hospital infection control program were reduced to 10 elements. 10 elements are as follows ; 1) Hospital administrator's knowledge of importance and necessity for HIC(hospital infection control) 2) Supporting HIC administratively 3) Constituting infection control committee and role of ICC 4) Developing an eductional program and providing a work manual for the hospital infection control staff 5) Educating and informing medical staff about hospital infection 6) Surveillance for hospital infection 7) Developing patient care technique 8) Controlling the hospital environment 9) Executing regular health examination of all medical staff 10) Recruiting the medical staff sufficiently Three rankings of response rate about 32 elements are as follows ; 1) Hiring a full tim staff member for the HIC(66%) 2) Establishing a hospital policy and standards for the HIC(66%) 3) Activating the infection control committee and taking administrative action to support the ICC(63%) In addition the rankings of importance score by Likert 5 scale are as follows ; 1) Washing hands scrupulously(4.88) 2) Nurses participation as key members of the ICC(4.75) 3) Reviewing and evaluating all ongoing aseptic techniques (4.69) In conclusion, first of all, administrative support must be given to hiring a full time staff member and to organization of infection control committee for the HIC in Korea.

• 대한관절경학회지
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• 제1권1호
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• pp.116-122
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• 1997

We have studied the results of reconstruction by freeze-dried patellar allografts or patellar autografts in ACL-deficient patients prospectively. From January 1995 to December 1995, we performed ACL reconstruction using an arthroscopic-assisted technique with patellar autografts in 21 patients and patellar allografts in 13 patients. Minimum followup time was 1 year(average 26 months). All patients were evaluated by using KT-2000 arthrometer and MRI as well as by physical examination. Final results were rated as satisfactory or unsatisfactory by using a modified Feagin knee scoring scale. Good or excellent were considered to have satisfactory results and fair or poor were considered to have unsatisfactory results. As measured by the KT-2000, 19 cases$(90.5\%)$ had a 5-mm or Jess side-to-side differential, a satisfactory results in autograft group, 2 cases of unsatisfactory results had joint instability. In allograft group, 10 cases$(76.9\%)$ had a 5-mm or less side-to-side differential, a satisfactory results, 3 cases of unsatisfactory results had joint instability including postoperative infection(1 case). In conclusion, the results of ACL reconstruction with autografts were better than those with allografts. The problem of allograft reconstruction were rehydration, aseptic control and improper mechanical tensioning. So, we thought that success of allograft reconstruction was depended on careful implant preparation including pretensioning technique.

• 대한족부족관절학회지
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• 제18권2호
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• pp.76-79
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• 2014

In treatment of failure in ankle joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation, treatment of large bone defects is considerably important for ankle joint stability and union, therefore, the choice of treatment for large bone defects is use of femoral head or iliac crest bone graft and rigid internal fixation. Because first generation total ankle arthroplasty performed for the first time using a cemented fixation technique requires a large amount of bone resection during re-surgery and there is some possibility of a larger bone defect after removal of implants, in cases where prosthesis for the defect is needed, performance of palliative femoral head or iliac crest bone graft and rigid internal fixation can be difficult. We report on a case of a 48-year-old woman who had experienced ankle pain for 25 years since undergoing total ankle arthroplasty. Because the patient had little ankle motion and rigid soft tissue despite a large bone defect caused by aseptic loosening, a good outcome was obtained only for the femoral cancellous bone graft using allo femoral head without internal fixation.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• 대한간호학회지
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• 제29권3호
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• pp.614-624
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• 1999

The purpose of this study is to determine the effectiveness of routine meatal care on the reduction of catheter-associated urinary tract infection (UTI). The study was carried out on 30 patients with foley catheters in an intensive care unit of a general hospital from September 30 to April 1, 1998. Participants were both male and female. Data were collected from each patients by urinary specimen obtained with aseptic collection technique at the 3rd and the 7th day of the experiment after giving daily mental care with 10% betadine for periods ranging from 1st to 7th day to the experimental group but not to the control group. The results are as follows : 1. The rate of urinary tract infection within the experimental group was 0.0%, at the 3rd day of the experiment and 20.0% at the 7th day, but that of the control group was 20.0% at the 3rd day and 7% at the 7th day. There was a significant difference in urinary tract infection rate between the two groups at the 3rd day but no significant difference at the 7th day. 2. In the control group, the rate of UTI was 0.7% for male and 13.3% for female at the 3rd day, and 6.7% for male and 40% for female at the 7th day. In the experimental group, the rate of UTI was 6.7% for male and 0.0% for female at the 3rd day and 13.3% for male and 20% for female at the 7th day of experiment. There was a no significant difference between male and female. 3. By comparing the rate of UTI to the length of time the urinary catheter was in place, the longer the catheter was in place the more significant was the rate of UTI. 4. Microorganisms isolated in the control group were bacteria for 7 cases and fungus for 3 cases but in the experimental group, only 2 cases of bacteria were isolated.

• 대한간호학회지
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• 제37권2호
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• pp.185-191
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• 2007

Purpose. The purpose of this study was to develop and evaluate an error reporting promoting program(ERPP) to systematically reduce the incidence rate of nursing errors in operating room. Methods. A non-equivalent control group non-synchronized design was used. Twenty-six operating room nurses who were in one university hospital in Busan participated in this study. They were stratified into four groups according to their operating room experience and were allocated to the experimental and control groups using a matching method. Mann-Whitney U Test was used to analyze the differences pre and post incidence rates of nursing errors between the two groups. Results. The incidence rate of nursing errors decreased significantly in the experimental group compared to the pre-test score from 28.4% to 15.7%. The incidence rate by domains, it decreased significantly in the 3 domains-"compliance of aseptic technique", "management of document", "environmental management" in the experimental group while it decreased in the control group which was applied ordinary error-reporting method. Conclusion. Error-reporting system can make possible to hold the errors in common and to learn from them. ERPP was effective to reduce the errors of recognition-related nursing activities. For the wake of more effective error-prevention, we will be better to apply effort of risk management along the whole health care system with this program.

• 식물조직배양학회지
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• 제26권4호
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• pp.271-274
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• 1999

아배양을 통한 물박달나무 성숙목의 기내증식은 DKW 배지에서 양호하였다. 이 배지는 다른 두 배지보다 줄기증식 및 줄기생장이 양호하여 물박달나무의 적정 배지로 생각되었다. DKW 배지에서 액아배양과 정아배양에는 큰 차이는 없었으나 증식에는 액아배양이, 생장에는 정아배양이 다소 양호하였다. 한편 1/2 MS 배지에서는 절편기부에 callus가 직경 1.0cm이상 지나치게 형성되어 줄기신장을 억제하였고, WPM에서는 줄기형태는 정상이나 생장이 저조하여 물박달나무의 아배양 배지로는 부적당하였다. 발근은 NAA 처리가 IBA 보다 효과적이었다. l/2 DKW 배지에 1.0 mg/L NAA 처리로 80%의 기내발근 되었으며 유도된 뿌리수도 많았다 얻어진 줄기는 직접 기외삽목도 가능하였는데, 이 같은 결과는 물박달나무 성숙목의 효율적인 기내번식이 가능함을 시사한다.

• 한국미생물학회:학술대회논문집
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• 한국미생물학회 2000년도 International Meeting 2000
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• pp.94-101
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• 2000

We investigated the viral contamination of water environment including tap water in Korea. River water used for source water was analyzed about monthly between 1997 and 1999 over a period 26 months. A total of 22 tap water samples were collected in 10 sites in 2 urban areas between 1997 and 1998 over a 11 months. All samples were examined for infectious enteroviruses and adenoviruses by a cell culture technique followed by PCR amplification. To identify the recovered viruses from tap water, sequence analysis of PCR products was performed. Infectious viral particles were detected in river water all year round, ranging from 0.93 to 17.3 Most Probable Number of Infectious Unit (MPNIU) /100L. Tap water samples also contained infectious viral particles. The frequency of enteroviruses and adenoviruses in tap water were $50.0\%$ (11/22) and $36.7\%$ (8/22), respectively. Both enteroviruses and adenoviruses were detected in five tap water samples $(22.7\%)$. The level of viral contamination in tap water was quite high, ranging from 0.2 to 2.9 MPNIU/100L, far above the recommended virus level in drinking water set by the U.S. EPA. Poliovirus type 1 derived from vaccine was frequently detected and the remainder comprised coxsackievirus B type or echovirus type 6, which were causative agents of aseptic meningitis in Korea in 1997 and 1998, respectively. Several types of adenovirus were detected in tap water samples and some water samples were found to contain adenoviruses which were closely related to enteric adenovirus type 40 and 41. This stusy shows that surface water and tap water in Korea may be exposed to the risk of viral contamination, especially from recently recognized viruses and this constitutes a potential public health hazard.

• 대한치과교정학회지
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• 제39권3호
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• pp.177-184
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• 2009

Objective: The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients. Methods: This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre- and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles. Results: Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all. Conclusions: The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p > 0.05).