• Archives of Plastic Surgery
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• v.36 no.4
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• pp.512-515
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• 2009

Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

• Physical Therapy Korea
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• v.3 no.3
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• pp.67-81
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• 1996

This study was performed to assess the efficacy of high voltage pulsed galvanic current for the healing of wounds in rabbits. Skin wounds were created laterally on the flank of 12 domestic rabbits($3{\times}3cm$). The wounds of each group were treated with an intensity of 170 V at a frequency of 70 pulses per second, which was applied for 30 minutes a day for 10 days. The experimental groups were randomly assigned to either EXP I (n=3), EXP II(n=3), EXP III(n=3) or control(n=3). Each group was stimulated under the following conditions : 1) EXP I (Negative polarity), 2) EXP II (Change in polarity, negative electrode stimulation during the first 3 days and then positive electrode stimulation from 4 to 10 days), 3) EXP III(Positive polarity), 4) control(No stimulation). An active electrode was placed over the wound and a dispersive electrode on the buttock. The rate of wound closure was compared with the original wound size, evaluated by a tracing film in each measurement period. Finally, on the wound in each group, skin tissue was excised for histological evaluation after treatment for 10 days. The results obtained are as follows : 1) It was found that the control group did not show a complete remodeling of epitherial layer and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue, these findings show that wound healing was delayed. 2) EXP I showed a significant bactericidal effect, but a moderate response of vasodilation. The rate of wound closure was slower when compared with EXP II, III. 3) EXP II showed a complete remodeling of epitherial layer and a positive repair of connective tissue. Its rate of wound closure was best when compared with the others. 4) EXP III had a slower rate of wound closure than EXP II, but judging from the greater proliferation of collagen fibers and the dense alignment of connective tissue, this positive electrode was very effective in the formation of neo - connective tissue.

• Tuberculosis and Respiratory Diseases
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• v.38 no.1
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• pp.34-44
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• 1991

Restoration of skin reactivity to 1 TU of tuberculin (RT23) by repeated tests at 10 days interval has been investigated in the BCG vaccinated or unvaccinated primary school children. The results obtained are as follows. 1) Tuberculin reactors showing 6 mm or larger induration to the first tests were 20.0% in the first grade school children and 33.3% in the sixth grade children. Six millimeter or larger reaction than that of the first reaction was found in 14.9% of the first grade children and in 34.6% of the sixth grade children. 2) Six millimeter or larger reactors were 10.8% of the first grade children without BCG scar against both first and second tests and 11.8% of the sixth grade children on first tests and 10.6% on second tests. There was none or very few, if any, in number of 6 mm or larger difference between the first and second tests among children without BCG scar. In addition, there was no children shown 6 mm or larger second reaction than that of the first reaction and thus those reactors seemed to be natural infection. 3) From questionaire survey, parents of 73.3% of the first grade children and of 72.7% of the sixth grade children were aware of BCG vaccination of their children, while parents of 15.1% and 24.6% of the first and sixth grade children did not know their children's vaccination history even if children possessed BCG scar. 4) Of the first grade children whose parents remembered their BCG vaccination, 65.6% were vaccinated within 4 weeks after birth and 25.5% between 4 weeks and one year. Six millimeter or larger reaction on the first tests was observed in 20.2% of the former group and 15.9% of the latter group, however reactors on the second tests were 32.1% and 31.9% respectively. BCG scar was not observed in 13.9% of children. 5) The majority of children (87.3%) were vaccinated in the skin of deltoid area and some (7.7%) at buttock or other areas. Children received first vaccination at the health centers were 68.5% and 30.3% at hospitals. More than 5 mm reaction was found in 18.7% of the former children and in 15.0% of the latter children. From this study restoration of tuberculin reactivity by repeated tests was found very common among the vaccinated children and thus it should be taken into account for the vaccination policy if it is performed after tuberculin testing.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.152-158
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• 2023

Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.130-138
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• 1996

Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.43-56
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• 1996

As considering a study of the So-um-In and So-yang-In desease, I know each of Extra-disease (表病) and Intra-disease (裏病). I takes serious view of the Extra-Intra-Um-Yang-Up-Down (表裏陰陽升降). I try to join costitutional disease to the parts of human body, which base on the theory on Sa-sang constituional Medicine. And I make some diagrams of them. They could be summerized as follows. 1.The Extra-qi (表氣) is four-viscera (四臟) and four back parts of hurman body (後四海). The Intra-qi (裏氣) is four-digestive organs (四腑) and four fore parts of human body (前四海). 2. It is important that Yang-qi (陽氣) go up at So-um-In Extra-disease (少陰人 表病) and Um-qi (陰氣) go down at So-yang-In Extra-disease (少陽人 表病). And It is important that Um-qi (陰氣) go down at So-um-In Intra-disease (少陰人 裏病) and Yang-qi of Large Intestine (大關局) go up at So-yang-In Intra-disese (少陽人 裏病). 3. Looking into the Extra-disease, ◈ Sin-Yang-Gon-Yiel (腎陽困熱) and Ha-Cho-Chuk-Hyel (下篇蓄血) of So-um-In disease are the disease that Yang-qi don't go up from the buttock. So-Yang-sang-Pung (少陽傷風) of So-yang-In disease is the disease that Um-qi don't go down from the upper back. ◈ Yui-Ga-Sil (胃家室) of So-um-In disease is the disease that Yang-qi don't go up from the lower abdomen Gyel-Hung (結胸) of So-yang-In disease is the disease that Um-qi don't go down from the thorax. ◈ Mang-Yang (亡陽) of So-um-In disease is the disease that Yang-qi don't go up from Intra-qi so it go out to the Extra-qi. Mang-Um (亡陰) of So-yang-In disease is the disease that Um-qi don't go down from the Extra-qi so it go into the Extra-qi. ◈ Dea-Jang-Pa-Han of So-um-In disease and Sim-Ha-Gyel-Hung (心下結胸) of So-yang-In desease are half of Extra-qi and Inrea-qi. 4. Looking into the Intra-disease, ◈ The Intra-disease of So-um-In is Tae-um symtom (太陰證) and So-um symtom (少陰證). The So-um symtom is more severe than Tae-um symtom because a cold wave of Large Intestine (大腸冷氣) involve a warm wave of Stomach (胃局). ◈ The Intra-disease of So-yang-In is not to go up Yang-qi of Large Intestine. Deficit of Yang-qi from Large Intestine which go up at Stomach is more sever than deficit of Yang-qi from Stomach which go up at extremes.