• Title/Summary/Keyword: Early-onset

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Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

  • Woo, Eun-Kyung;Lee, Jong Wook;Hur, Gi-Yeun;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.510-516
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    • 2013
  • Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

Salvage of Infected Breast Implants

  • Song, Joon Ho;Kim, Young Seok;Jung, Bok Ki;Lee, Dong Won;Song, Seung Yong;Roh, Tai Suk;Lew, Dae Hyun
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.516-522
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    • 2017
  • Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

Surgical Treatment of the Aortic Aneurysm (대동맥류의 외과적 치료)

  • 김학제;조원민;김태식;이송암;김욱진;손영상;최영호
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.13-19
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    • 1998
  • Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

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A Case of Childhood-Onset Niemann Pick Type C Disease (소아기에 발현한 C형 Niemann Pick 병 1례)

  • Jung, Jiwon;Seo, Go Hun;Oh, Arum;Jin, Hee Kyung;Bae, Jae-Sung;Kim, Gu-Hwan;Yoo, Han-Wook;Lee, Beom Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.1
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    • pp.30-34
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    • 2018
  • Niemann Pick type C disease (NPC) is an inherited progressive neurodegenerative disorder, due to defects of intracellular lipid trafficking and storage. Hepatosplenomegaly may prevail, while progressive neurodegenerative symptoms such as cerebellar involvement, dystonia, vertical supranuclear ophthalmoplegia, cataplexy, and eventually seizures starting at juvenile or late infantile period may accompany after normal early development. Here we describe a 3-year-old Korean boy with NPC who presented with splenomegaly at age 3. Liver biopsy showed characteristic foamy cell stained by periodic acid-schiff, and molecular analysis for NPC1 identified the compound heterozygous mutations, novel mutation of c.1631G>A (p.Trp544Ter) and c.2662C>T (p. Pro888Ser) as a known mutation. Filipin was strongly stained with unesterified cellular cholesterol in the patient's skin fibroblasts. The patient has received migulstat since age 3 years and his long-term outcome is needed to be observed.

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A survey of the status of hair loss product use, hair loss treatment and satisfaction level (탈모(脫毛) 고객(顧客)의 제품이용실태와(製品使用實態) 관리(管理) 및 만족도(滿足度) 조사(調査))

  • Lee, Ji-Suk;Kim, Sung-Nam
    • Journal of Fashion Business
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    • v.11 no.2
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    • pp.76-91
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    • 2007
  • The domestic market for scalp care and hair loss management reached 1 trillion won. The market for hair loss management is expected to expand further. Systematic scalp and hair care services, such as scalp scaling, scalp massage, equipment maintenance, scalp care products sale, and care program based on scalp and trichology are provided. This study examined the status of hair loss management and use of hair care products by people experiencing hair loss and the level of their satisfaction. In addition, this study presents basic data for the effective hair loss management and marketing strategies for scalp and hair loss clinics. The results are as follows. 41.2% of the study subjects were in their 20s, and 66.6% of the study subjects were women. As for the hair loss symptoms, 45.2%, the largest percentage, had thin and wispy hair and more women had thin hair than men. 80.0% of men had oily hair. As for the scalp condition, 39,3% had oily scalp. As more women experience hair loss, 39.6% had female pattern hair loss and 31.0% had male pattern hair loss. As the largest percentage of people experiencing hair loss was in their 20s, 33.4%, the largest percentage, had the onset of hair loss in their early 20s. 34.1%, the largest percentage, reported having used the clinic for less than 1 month. The older the subject, the longer the length of hair clinic use. As for the average number of monthly hair loss clinic visits, 28.2%, the largest percentage, said 3 times. As for the hair loss management product use, 61.9%, said they do not use it and 38.1% said they use it. 5.6%, the largest percentage, used Davines at home and 9.6%, the largest percentage, used Kerastase at the clinic. As for the experience of hair loss product previously, 84.5% said they had no experience and 15.5% said they had eThe following are related to the satisfaction level of hair loss management. xperience. 5.0%, the largest percentage, reported having used Daenggimeori. The following are related to the satisfaction level of hair loss management. 32.8%, the largest percentage, said the effect of hair loss management lasted less than 6 monthas. As for the satisfaction levels on hair loss management program, service, skill of the hair specialist, hygiene, and hair loss management products, most people indicated between average and somewhat satisfactory levels. As for the satisfaction level on the cost of hair loss management, most people indicated average satisfaction level. As for the element essential to hair loss management, 39.0%, the largest percentage, indicated development of effective and specialized programs, 28.2%, indicated low price, 25.1%, indicated systematic and professional education of the hair specialist, 4.6%, indicated marketing and promotion, 2.5%, indicated service quality, and 0.6% indicated others.

Cellular and Molecular Roles of $\beta$ Cell Autoantigens, Macrophages and T Cells in the Pathogenesis of Automimmune Diabetes

  • Yoon, Ji-Won;Jun, Hee-Sook
    • Archives of Pharmacal Research
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    • v.22 no.5
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    • pp.437-447
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    • 1999
  • Type I diabetes, also known as insulin-dependent diabetes mellitus (IDDM) results from the destruction of insulin-producing pancreatic $\beta$ cells by a progressive $\beta$ cell-specific autoimmune process. The pathogenesis of autoimmune IDDM has been extensively studied for the past two decades using animal models such as the non-obese diabetic (NOD) mouse and the Bio-Breeding (BB) rat. However, the initial events that trigger the immune responses leading to the selective destruction of the $\beta$ cells are poorly understood. It is thought that $\beta$ cell auto-antigens are involved in the triggering of $\beta$ cell-specific autoimmunity. Among a dozen putative $\beta$ cell autoantigens, glutamic acid decarboxylase (GAD) has bee proposed as perhaps the strongest candidate in both humans and the NOD mouse. In the NOD mouse, GAD, as compared with other $\beta$ cell autoantigens, provokes the earliest T cell proliferative response. The suppression of GAD expression in the $\beta$ cells results in the prevention of autoimmune diabetes in NOD mice. In addition, the major populations of cells infiltrating the iselts during the early stage of insulitis in BB rats and NOD mice are macrophages and dendritic cells. The inactivation of macrophages in NOD mice results in the prevention of T cell mediated autoimmune diabetes. Macrophages are primary contributors to the creation of the immune environment conducive to the development and activation of $\beta$cell-specific Th1-type CD4+ T cells and CD8+ cytotoxic T cells that cause autoimmune diabetes in NOD mice. CD4+ and CD8+ T cells are both believed to be important for the destruction of $\beta$ cells. These cells, as final effectors, can kill the insulin-producing $\beta$ cells by the induction of apoptosis. In addition, CD8+ cytotoxic T cells release granzyme and cytolysin (perforin), which are also toxic to $\beta$ cells. In this way, macrophages, CD4+ T cells and CD8+ T cells act synergistically to kill the $\beta$ cells in conjunction with $\beta$ cell autoantigens and MHC class I and II antigens, resulting in the onset of autoimmune type I diabetes.

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Distal Myopathy with Rimmed Vacuoles Confirmed by Whole Exome Sequencing (Rimmed vacuole을 가진 원위부 근육병증의 전체 엑솜 서열분석을 이용한 유전적 원인 규명)

  • Seo, Seong Don;Park, Hyung Jun;Song, Hyun Seok;Kim, Hye Jin;Park, Jin-Mo;Hong, Young Bin;Chung, Ki Wha;Choi, Byung-Ok
    • Journal of Life Science
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    • v.24 no.3
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    • pp.311-317
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    • 2014
  • Distal myopathy with rimmed vacuoles (DMRV) or hereditary inclusion body myopathy 2 is an autosomal recessive muscular disorder characterized by early adult-onset weakness of distal muscles and rimmed vacuoles in muscle biopsy. Mutations in the UDP-N-acetylglucosamine 2-epimerase/N-ace-tylmannosamine kinase (GNE) gene are associated with the development of DMRV. In this study, whole exome sequencing (WES) revealed compound heterozygous GNE mutations of p.Asp176Val and p.Val572Leu in a patient with distal limb weakness. Three hundred healthy controls did not show these mutations. All other variants found in distal myopathy-relevant genes were polymorphic. These findings confirmed that the patient had DMRV. This work underscores the usefulness of WES in improving the molecular diagnosis of myopathy.

Postmortem Changes in Muscle of Sea Water Acclimated Tilapia, Oreochromis niloticus (해수순치한 틸라피아 근육의 사후변화)

  • Yoon Ho-Dong;KIM Tae-Jin;KIM Seong-Jun;LEE Jong-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.29 no.3
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    • pp.279-286
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    • 1996
  • Cultivated tilapia (Oreochromis niloticus) in the fresh water were acclimated to the sea water to improve palatability of the fish meat. Physicochemical properties in the rigor mortis of those fish meats were investigated during storage at $0^{\circ}C,\;10^{\circ}C\;and\;20^{\circ}C$. The faster onset of rigor mortis was occurred in acclimated meat than fresh water cultivated meat. Both meats stored at $0^{\circ}C$ showed faster figro mortis than at $10^{\circ}C\;and\;20^{\circ}C$. Significant difference was not observed between the breaking strength and the rigor index. The breaking strength reached maximum over 12hrs after death and then gradually declined, and the rigor index was slowly increased and reached maximum over 18hrs after postmortem. Low temperature and acclimation to the sea water affected the degradation of adenosine triphosphate (ATP), accumulation of inosine monophosphate (IMP) or lactate. These results suggest that the palatability of tilapia muscle cultivated in the fresh water could be improved by acclimation to the sea water which induces the prerigor at the early state of postmortem and the physical changes of fish muscle.

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Sleep-Wake Cycles in Man (인간의 수면-각성 주기)

  • Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.147-155
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    • 1997
  • To assess the reliability of chronobiological models of sleep/wake regulation, it is necerssary that the models predict the data which has been studied in sleep research, and they should be generalized across all ages. To date, many adult human data on such models have accumulated, yet it is evident that a comprehensive theory of the biorhythmic aspects of sleep/wake states has not established. Circadian rhythms such as the time going to bed, sleep onset, slow wave sleep pressure, periodicity of REM sleep, daytime performance, and early evening alertness are resumed everyday. Even in adult humans, sleep is inherently polyphasic. In both the disentrained and entrained states, naps when allowed tend to recur in a temporally lawful manner. The monophasic sleep pattern of most industrial societies therefore appears to be purely of social origin. The endogenous biorhythmic nature of circasemidian sleep tendency is supported by the ubiquity of the phenomenon across all ages. The NREM/REM sleep cycle within sleep with its inherent physiological, endocrine, and neurochemical fluctuations represents the best-documented ultradian sleep rhythms. Also, a daytime ultradian variation in sleepiness with a periodicity similar to nocturnal NREM/REM cycle(BRAC hypothesis) is suggested. This review article provides a brief synoptic review of the evidences for circadian, circasemidian, and ultradian sleep/wake rhythms, and then the authour will suggest the issues which expedite fuller modeling of sleep/wake system, to be further discussed.

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A Clinico-Statistical Study of the Biopsy Result of the Larynx (이비인후과외래에서 시행한 후두조직생검 142례의 임상통계적 고찰)

  • 고건성;유장열;황순재;임상혁;박현수;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.5.2-6
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    • 1978
  • The prognosis of the laryngeal diseases is highly dependent on the early diagnosis and treatment. The biopsy finding is inevitable for the cofirmed diagnosis. A clinico-statistical survey of the biopsy result of the larynx in 142 cases was done at the Department of the Otolaryngology Seoul National University Hospital during a period of 3 yrs from 1973 to 1975. Results are as follows 1. Of the 142 cases, 109 cases (76.8%) were males and 33 cases (23.2%) females. Sex ratio was 3.3 : 1. 2. Age distribution shows 41 cases (28.8%) in 5th decade, 41 cases (28.9%) in 6th decade. 3. Chief complaint was hoarseness 127 cases (89.4 %), dysphagia 7 cases (4.9%) and sore throat, dyspnea etc. The time lag from the onset of hoarseness to the hospital was 2∼6 Months, 56 cases (44.0%), 6 Months∼l yrs, 34 cases (24%), within 2 Months, 17 cases (13.4%) and 15 cases (11.8%) were over 3yrs. Average time lag was 8.1 Months. 4. The site of laryngeal biopsy was 76 cases (53.3 %) from ture vocal cord, 23 cases (16.2%) from false vocal cord, and 19 cases (13.3%) from epiglottis. 5. Biopsy result was carcinoma in 69 cases (48.6%), laryngeal nodule in 20 cases (14.0%), laryngeal tuberculosis in 12 cases (8.4%) and non specific inflamation in 7 cases (5.0%). 6. 13.4% of the clinically impressed laryngeal carcinoma proved to be laryngeal tuberculosis, nonspecific inflammation etc.

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