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Long-term Result of Nipple Reconstruction Using Skate Flap after Breast Reconstruction (유방재건 후 Skate 피판을 이용한 유두재건술의 장기추적결과)

  • Kim, Deok-Yeol;Dhong, Eun-Sang;Yoon, Eul-Sik;Son, Gil-Su
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.401-407
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    • 2011
  • Purpose: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. Methods: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, followup period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. Results: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were $17.0{\pm}13.99%$, $25.0{\pm}12.70%$, $30.0{\pm}12.57%$ and $30.8{\pm}12.49%$ at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. Conclusion: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.

Clinical Analysis of 60 Patients with Hepatocellular Cancer Treated in Korean Medicine Hospital; A Retrospective Chart Review (단일 한방병원에 내원한 간암환자 60명에 대한 임상적 특징 분석; 후향적 차트 리뷰)

  • Yoon, Mi-jung;Cho, Na-kyung;Choi, Hong-sic;Kim, Seung-mo;Kim, Sang-chan;Kim, Kyung-soon
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.447-456
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    • 2020
  • Objectives: This review aimed to present the characteristics of hepatocellular cancer patients treated by Korean medicine. Methods: Sixty hepatocellular cancer patients in a Korean medicine hospital from July 2012 to December 2019 were studied. We evaluated the general characteristics, overall therapies, and chief complaints of the patients. Results: Of the patients, 55% were stage IV, and Korean medicine was accompanied by conventional treatments, such as chemotherapy, operation, and transarterial chemoembolization. An average number of hepatocellular cancer patients had admitted to the hospital. The patients' chief complaints were dyspnea, general weakness, abdominal discomfort, and cancer-related pain. Conclusions: This study illustrates the general characteristics of hepatocellular cancer patients on Korean medicine treatments. These findings suggest that further investigations with a rigorous study design and more participants are needed.

Drug Use Evaluation of Vancomycin in Hospitalized Patients of Surgery Departments (외과계 입원환자에 대한 Vancomycin의 약물사용 평가)

  • Lee, Young Mee;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.35-43
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    • 1999
  • Over the last 50 years, a number of antibiotic agents have been developed and clinically used in the area of infectious diseases. Due to antimicrobial resistance problems and increasing health care costs, the rational use of antibiotics has been required. As a drug of choice to treat infections caused by MRSA, vancomycin has been extensively prescribed since the late 1970's. Recently, reports of vancomycin-resistant organisms such as VRE and VRSA have been increased to draw medical concerns. The objectives of this study were to evaluate the rational use of vancomycin and the appropriateness of the Restrictional Program of Antibiotic Utilization (RPAU) which has been operated at Samsung Medical Center. A retrospective chart review was performed in 132 hospitalized patients treated with vancomycin in the surgery departments from. January to June 1998. The guidelines of ASHP and HICPAC for vancomycin were modified and used as our criteria to determine the vancomycin DUE. In one hundred out of the patients, uses of vancomycin were approved by the Department of Infectious Diseases (DID) based on the RPAU. Vancomycin was appropriately used in $62.5\%$ of the 100 patients according to the criteria of justification of use, while $60.0\%,\;60.0\%,\;79.0\%,\;and\;51.0\%$ of the patients showed appropriate according to those of lab reports such as applicable culture obtained, pretreatment SCr, WBC and serum drug concentration monitoring, respectively. Although the rest 32 patients were not approved to receive vancomycin by the DID, twenty two percent continued receiving vancomycin treatment. This might result from the fact that the RPAU was started not before the use of antibiotics but in the middle of antimicrobial therapy. Continual education should be provide to the related health professionals and the RPAU should be simultaneously modified in order to increase the rate of appropriate uses of antibiotics.

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A New Euphorbia Cultivar 'Panorama' with Green and Pink Colored Bract (녹색과 분홍색의 포를 가진 다육식물 꽃기린 신품종 '파노라마' 육성)

  • Park, Heung-Bae;Nam, Sang-Yong;Chung, Jae-Woon;Lee, Jung-Jin;Park, In-Tae
    • Korean Journal of Breeding Science
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    • v.42 no.6
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    • pp.717-720
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    • 2010
  • A new cultivar of Euphorbia milii, 'Panorama' was developed at Cactus Research Institute, Gyeonggi-do Agricultural Research & Extension Services in 2009. 'Gabi' and 'Maxi' were crossed in 2001 and three $F_1$ seedlings were obtained. Pedigree selection was performed in 2002. One line was finally selected and named as 'Panorama' through the test of specific character from 2007 to 2009. The new cultivar 'Panorama' has green and pink colored bract, and it has 2~3 each of inflorescence number, 2.0 cm of bract width, 4.3 each of lateral shoot and 14.9 cm of plant height. Characters of the cultivar can be maintained by vegetative propagation.

Validation of Administrative Big Database for Colorectal Cancer Searched by International Classification of Disease 10th Codes in Korean: A Retrospective Big-cohort Study

  • Hwang, Young-Jae;Kim, Nayoung;Yun, Chang Yong;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Son, Il Tae;Oh, Heung-Kwon;Kim, Duck-Woo;Kang, Sung-Bum;Lee, Hye Seung;Park, Seon Mee;Lee, Dong Ho
    • Journal of Cancer Prevention
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    • v.23 no.4
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    • pp.183-190
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    • 2018
  • Background: As the number of big-cohort studies increases, validation becomes increasingly more important. We aimed to validate administrative database categorized as colorectal cancer (CRC) by the International Classification of Disease (ICD) 10th code. Methods: Big-cohort was collected from Clinical Data Warehouse using ICD 10th codes from May 1, 2003 to November 30, 2016 at Seoul National University Bundang Hospital. The patients in the study group had been diagnosed with cancer and were recorded in the ICD 10th code of CRC by the National Health Insurance Service. Subjects with codes of inflammatory bowel disease or tuberculosis colitis were selected for the control group. For the accuracy of registered CRC codes (C18-21), the chart, imaging results, and pathologic findings were examined by two reviewers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC were calculated. Results: A total of 6,780 subjects with CRC and 1,899 control subjects were enrolled. Of these patients, 22 subjects did not have evidence of CRC by colonoscopy, computed tomography, magnetic resonance imaging, or positron emission tomography. The sensitivity and specificity of hospitalization data for identifying CRC were 100.00% and 98.86%, respectively. PPV and NPV were 99.68% and 100.00%, respectively. Conclusions: The big-cohort database using the ICD 10th code for CRC appears to be accurate.

The Retrospective Study for the Effect of Traditional Korean Medicine on Patients with Olfactory Disorder after Failure of Steroid Treatment (스테로이드 치료에 반응하지 않은 후각장애 환자에 대한 한방치료의 효과)

  • Park, So-Young;Kim, Min-Hee;Kang, Min-Seo;Kwak, Jae-Young;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.2
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    • pp.59-67
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    • 2019
  • Objectives : The purpose of this study was to analyze the effects of traditional korean medicine treatment on patients with olfactory disorder who did not respond to steroid treatment. Methods : A retrospective chart review was conducted on 16 patients who visited the outpatient clinic with olfactory disorder for over 1 month. The patients were treated with Herbal medicine, acupuncture, electronic moxibustion, intranasal pharmacopuncture, and olfactory training. The treatment effect was evaluated by KVSS I test. Results : There was no significant difference in KVSS I test score according to sex, age, duration of treatment, number of treatment, the days after onset. There was no significant difference in the KVSS I test scores before and after the treatment for the cases of sinonasal disease, head trauma, and idiopathic cases. However, there was a significant difference in cases of post-viral olfactory disorder. Conclusion : Traditional korean medicine may be effective for patients with post-viral olfactory disorder that did not show improvement in steroid treatment.

Childbirth outcomes and perineal damage in women with natural childbirth in Korea: a retrospective chart review (자연주의 출산한 여성의 출산실태와 회음부 손상: 일개 자연주의 출산병원 의무기록을 중심으로)

  • Kim, Kyung Won;Lee, Sunhee
    • Women's Health Nursing
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    • v.27 no.4
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    • pp.379-387
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    • 2021
  • Purpose: This study aimed to determine the actual state of childbirth in Korean women with natural childbirth and the degree of damage to the perineum during childbirth. Methods: This retrospective study analyzed the medical records of mothers who had natural childbirth at a hospital in Seoul, Korea in 2018. Data from 358 women with cephalic births at greater than 37 gestational weeks were analyzed. To determine natural childbirth characteristics and the degree of damage to the perineum, descriptive statistics were done. The difference in the degree of perineal injury according to obstetric characteristics was analyzed using independent t-test and one-way analysis of variance. Results: The mean age was 33.18±3.68 years, and 49.2% were primiparas, while 39% gave birth with a doula. The degree of perineal damage differed by age (F=9.15, p<.001), parity (t=19.13, p<.001), number of births in multiparity (F=3.68, p=.027), previous vaginal delivery in multiparity (F=3.00, p=.032) and birthing posture (F=7.44, p<.001). Having received therapeutic procedures (t=-4.62, p<.001), specifically fluid administration (t=-2.72, p=.007), oxygen supply (t=-2.76, p=.006) and epidural anesthesia (t=-2.77, p=.006) were statistically significant for perineal damage. There were no differences, however, by gestational period, doula use, water room use in labor, baby head circumference, or birth weight. Conclusion: Study findings suggest that support for older women, primiparas, and those who require therapeutic procedures may help to decrease the possibility of perineal damage during childbirth. As perineal damage was also associated with birthing posture, this should be considered when providing intrapartum nursing care.

Low incidence of maxillary hypoplasia in isolated cleft palate

  • Azouz, Vitali;Ng, Marilyn;Patel, Niyant;Murthy, Ananth S.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.8.1-8.5
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    • 2020
  • Background: The cause of maxillary growth restriction in patients with cleft lip and palate remains controversial. While studies have investigated the effects surgical technique and timing have on maxillary growth, few focus on patients with isolated cleft palate (ICP). The purpose of this study was to determine the impact palate repair and its associated complications may have on maxillary growth. Methods: A retrospective chart review of ICP patients who underwent palatoplasty from 1962 to 1999 at Akron Children's Hospital was performed. Patient demographics, Veau type, age at primary repair, closure technique, presence of fistula or velopharyngeal insufficiency (VPI), number of palatal operations, maxillary hypoplasia (MH) frequency, and follow-up were recorded. Exclusion criteria included patients with cleft lip, submucous cleft, or syndromes. Results: Twenty-nine non-syndromic ICP patients were identified; 62% (n = 18) had Veau type 1 and 38% (n = 11) had Veau type 2. All patients underwent 2-flap or Furlow palatoplasty with mobilization of mucoperiosteal flaps. Vomerine flaps were used in all Veau 2 cleft palate closures. Palatoplasty was performed at a mean age of 19.9 ± 8.2 months. Average follow-up was 209 ± 66.5 months. The rate of VPI was 59% (n = 17) and the rate of oronasal fistula was 14% (n = 4). Conclusions: There was a low incidence of MH despite complications after initial palate closure. Our results seem to suggest that age at palate closure, type of cleft palate, and type of surgical technique may not be associated with MH. Additionally, subsequent procedures and complications after primary palatoplasty such as VPI and palatal fistula may not restrict maxillary growth.

Prevalence and factors associated with hyponatremia in older adults who visited emergency department (응급실을 방문한 노인 환자의 저나트륨혈증 유병률 및 위험인자 분석)

  • Kim, Geonnyeon;Shin, Sangmi;Suh, Yewon;Namgung, Hyungwook;Lee, Jeonghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.67-73
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    • 2022
  • Objectives: Hyponatremia is prevalent electrolyte disorder and can be fatal in older adults. Evaluative studies on hyponatremia among older adults are scarce, especially targeting for those who visited emergency department (ED). We aimed to estimate the prevalence and to identify risk factors of hyponatremia among elderly patients visiting the ED. Methods: A retrospective chart review was completed including 65 or older patients who visited ED at Seoul National University Bundang Hospital from September to December 2019. Patients with the serum sodium concentration of less than 130mEq/L was defined as a hyponatremia group. Logistic regression analysis was conducted to assess predictive factors for hyponatremia. Results: Of the total 2,445 patients, 155 (6.3%) were confirmed to have hyponatremia at the time of ED visits. Risk factors for hyponatremia identified in logistic regression analysis were thiazides (aOR=2.64, 95% CI 1.66-4.21), opioids (exclude tramadol) (aOR=3.45, 95% CI 1.72-6.94), and desmopressin (aOR=6.98, 95% CI 2.45-19.84). Compared to the use of thiazides alone, it was confirmed that the possibility of hyponatremia was more than quadrupled when proton pump inhibitor (PPI) was used together (aOR=4.08, 95% CI 1.74-9.55). Conclusions: About 6.3% of older adults visiting the ED had hyponatremia. Age, number of medications taken, previous history of hyponatremia, heart failure, cirrhosis, pneumonia, sepsis, prescribed drugs including thiazides, opioids (exclude tramadol), or desmopressin or taking PPI together with thiazides was confirmed to correlate with the risk of hyponatremia.

Outcomes Associated with Nasal Reconstruction Post-Rhinectomy: A Narrative Review

  • John, Jithin;Gupta, Rohun;Grossbauer, Anne;Chung, Michael;Sethna, Anita;Abboud, Michel;Cox, Eric;Hart, Justin;Folbe, Adam;Chaiyasate, Kongkrit
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.184-194
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    • 2022
  • The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.