• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.63-67
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• 2004

Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.376-384
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• 2020

Purpose: The role of prophylactic abdominal drainage in total gastrectomy is not well-established. This study aimed to evaluate the efficacy of abdominal drainage in the prevention and management of major intra-abdominal complications after total gastrectomy for gastric carcinoma. Materials and Methods: We retrospectively reviewed the data of 499 patients who underwent total gastrectomy for gastric carcinoma in a high-volume institution. The patients were divided into drainage and non-drainage groups and compared for the development and management of major intra-abdominal complications, including anastomotic leak, abdominal bleeding, abdominal infection, and pancreatic fistulas. Results: The drainage group included 388 patients and the non-drainage group included 111 patients. The 2 groups showed no significant differences in clinicopathological characteristics or operative procedures, except for more frequent D2 lymphadenectomies in the drainage group. After surgery, the overall morbidity (drainage group vs. non-drainage group: 24.7% vs. 28.8%, P=0.385) and incidence of major intra-abdominal complications (6.4% vs. 6.3%, P=0.959) did not significantly differ between the two groups. The non-drainage group showed no significant increase in the incidence rate of major intra-abdominal complications in the subgroups divided by age, sex, comorbidity, operative approach, body mass index, extent of lymphadenectomy, and pathological stage. Abdominal drainage had no significant impact on early diagnosis, secondary intervention or reoperation, or recovery from major intra-abdominal complications. Conclusions: Prophylactic abdominal drainage showed little demonstrable benefit in the prevention and management of major intra-abdominal complications of total gastrectomy for gastric carcinoma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.63-67
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• 2000

Purpose: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. Methods: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. Results: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. Conclusion: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.1
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• pp.87-101
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• 1995

This study was conducted with the subject of showing the importance of early rehabilitation and exercise therapy in patients who have stroke, of confirming the adavntage of ward exercise conducted by nurse, which had been conducted mainly by physical therapist only in physical thrapy room and of developing the exercise program as the independent rehabilitation nursing intervention. A total of 62 patients were selected as object from April, 5th, to May, 17th, 1995, who had been hospitalized in K medical center, and the half of them were assigned to Experimental group in ramdom assignment using a coin. It was ADL check list tool developed by Kang and Ward Exercise Program developed by the researcher that were used as a treatment. Ward Exercise Program was conducted by the reseacher and the physical therapist measured ADL score before and after Ward Exercise Program. The data were analyzed using ANOVA, pearson correlation, Chi-Square test and the effect of Ward Exercise Program was analyzed by t-tast. The result of this study is as follows. 1. The experimental group showed eminent improvement of ADL compared with the counter group with statistical significance. In eating(t=6.10, df=60, p=.000), personal hygiene performing(t=4.86, df=60, p=.000), wearing(t=5.86, df=60, p=.000), elimination(t=7.89, df=60, p=.000), mobility on the bed(t=13.36, df=60, p=.000), moving(t=9.11, df=60, p=.000), walking(t=7.45, df=60, p=.000) 2. There was no qualitative difference between experimental group and control group with the significance of $p{\le}.05$. 3. There was no relation between the general condition and the difference of ADL, while there was significant relation between the starting point of exercise and the difference of pre-exercise and post exercise ADL. As a result, it should be emphasized that the early rehabilitation and exercise therapy are important in patients who have stroke, and that it is necessary to extend the exercise therapy to the ward. Therefore, this Ward Exercise Program could be recommended as a independent clinical exercise nursing intervention in rehabilitation nursing of patients who have stroke.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.47-54
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• 2008

Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

• Clinical and Experimental Pediatrics
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• v.61 no.7
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• pp.221-225
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• 2018

Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.107-115
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• 2011

Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

• Journal of Korean Public Health Nursing
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• v.36 no.1
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• pp.75-89
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• 2022

Purpose: Domestic violence is an important issue encountered in nurses' home visitation programs. This study analyzed the types of domestic violence and associated interventions provided by nurses in a prenatal and early childhood home visitation program in Korea. Methods: For 24 families who experienced domestic violence in the Seoul Healthy First Step Project, registration information and home visit nursing records were analyzed through directed qualitative content analysis. Results: Physical violence was found in all 24 cases, followed by emotional violence, coercive control, financial abuse, and sexual violence. Twenty-two interventions derived from existing nurse-family partnership (NFP) program strategies were identified in the nursing practices of the Seoul Healthy First Step Project. Conclusion: In a prenatal and early childhood nurses' home visitation program in Korea, various approaches and interventions were provided to nurses to address domestic violence. However, differences in the level of interventions provided by nurses were found, implying a need to educate and support nurses to address domestic violence in-home visitation programs.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.270-276
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• 2020

Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.