• Archives of Plastic Surgery
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• v.39 no.5
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• pp.483-488
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• 2012

Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

• 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.

• Anxiety and mood
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• v.8 no.2
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• pp.93-98
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• 2012

Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.82-85
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• 1997

Destruction of the gasserian ganglion can be carried out by creating a radiofrequency lesion under biplanar fluoroscopic guidance. This procedure is reserved for patients who have failed various interventions for intractable trigeminal neuralgia including retro-gasserian injection of glycerol and whose physical status otherwise precludes more invasive neuro-surgical treatments such as microvascular decompression. Radiofrequency thermocoagulation of the gasserian ganglion provides a safe method of achieving long-standing relief from trigeminal neuralgia with low risk. This technique is currently emerging worldwide as the surgical treatment of choice for trigeminal neuralgia. Recently we performed a successful radiofrequency gasserian ganglionotomy, without any complication, under fluoroscopic guidance. The procedure was successful and complete pain relief was achieved for a patient who already had treatments of various interventions including microvascular decompression but never experienced pain relief.

• Journal of Korean Neurosurgical Society
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• v.45 no.4
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• pp.246-248
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• 2009

Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.250-254
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• 2005

Burns due to epileptic seizures are commonly deep and usually require operative treatment. The purpose of this study is to identify the characteristics of burned epileptic patients that could lead to the development of preventive programs to reduce the incidence of burn injuries. We analyzed epidemiological data for 34 patients acutely burned due to epileptic seizure admitted retrospectively. There were 15 male and 19 female subjects. The age distribution was from 6 years to 70 years with the mean age of 42.7 years. Seizures usually occurred while carrying out daily domestic chores. Scalding burns were the most common(38.2%) and most burns were above deep second degree(94.1%). The most common seizure type was generalized tonic-clonic, followed by absence and complex partial. The seizure mostly occurred in the morning because the therapeutic blood level of antiepileptic drugs was decreased extremely at that time by stopping drug arbitrarily or taking inadequately. So more frequent follow-ups at the neurology outpatient clinics for epileptics should be strictly reinforced to maintain the adequate therapeutic blood levels of antiepileptic drugs and fire protective implements should be prepared in the house.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.178-181
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• 2011

Congenital anomalies in arches of the atlas are rare, and are usually discovered incidentally. However, a very rare subgroup of patients with unique radiographic features is predisposed to transient quadriparesis after minor cervical or head trauma, A 46-year-old male presented with a 2-month history of tremor and hyperesthesia of the lower extremities after experiencing a minor head trauma. He said that he had been quadriplegic for about 2 weeks after that trauma. Radiographs of his cervical spine revealed bilateral bony defects of the lateral aspects of the posterior arch of C1 and a midline cleft within the anterior arch of the atlas. A magnetic resonance imaging revealed an increased cord signal at the C2 level on the T2-weighted sagittal image. A posterior, suboccipital midline approach for excision of the remnant posterior tubercle was performed. The patient showed significant improvement of his motor and sensory functions. Since major neurologic deficits can be produced by a minor trauma, it is crucial to recognize this anomaly.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.37-40
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• 2012

Honey is produced by bees from nectar collected from nearby flowers. Sometimes, honey produced from the Rhododendron species is contaminated by Grayanotoxin (GTX) in Nepal and other countries. There have been reports of GTX intoxication, also known as 'mad honey disease', from honey produced in countries other than Korea. The importation of wild honey has been prohibited by the Korean Food and Drug Administration since 2005, yet it is still distributed within Korea by the occasional tourist. We report a case of GTX intoxication from contaminated honey which included the symptoms of nausea, vomiting, general weakness, dizziness, blurred vision, hypotension and sinus bradycardia. By means of infusion with normal saline and atropine sulfate, the patient's condition fully recovered within 8 hours of hospital admission, and she was discharged without any complications.

• Journal of Korea Water Resources Association
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• v.42 no.7
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• pp.513-523
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• 2009

The measuring point of the Hangang Bridge affected by tide has some special topographic characteristics due to Nodle Island. Furthermore the submerged weirs located on the upstream and downstream. Therefore flow is separated and joined by Nodle Island. Discharge measurement at the point of the Hangang Bridge is very important, because Hangang Bridge is key station in managing the discharge and flood forecasting. In the past, it was too difficult to measure discharge in tidal conditions. HRFCO(Han River Flood Control Office) installed automatic discharge measurement facilities for solving this problem. Measuring equipments operates and measures discharge every 10 minutes at 2 points(southern and northern section close to Nodle Island), and calculates flow discharge using Chiu's velocity law(Chiu, 1988). In order to verify the results of automatic discharge measurements, manual discharge measurements were carried out by ADCP. In addition, the monthly discharge were also compared.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.64-69
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• 1999

Background: The new drug HP228 is a cytokine restraining agent with a broad spectrum of anti-inflammatory, analgesic, and antipyretic activity. Six healthy, adult, male volunteers were studied to determine the independent and interactive effects of HP228 and morphine on pain perception. Methods: Two groups of stimuli were applied to each volunteers before drug administration as control, 20 min after morphine and HP228 administration, and 20 min after combined administration of these two drugs. Two adhesive electrically-conducting pads were applied on opposite sides of the arm approximately 8 cm apart. The electrode were connected to an electrical impulse generator and 50 Hz 1 msec pulses of incrementally increasing intensity were delivered at 1 sec intervals. The analgesic endpoints were the current intensity (mA) at which the subject first detected the stimulus (THRESH), the intensity at which the stimulus was first idenfied as being painful (PAIN), and the intensity at which the subject requested that the stimulus be terminated due to discomfort (LIMIT). A second series of stimuli were applied immediately thereafter using 1-sec duration 50 Hz tetanus pulses with increasing intensities at 2~5 sec intervals. Results: There were significant differences between drug treatments (Morphine, HP228, HP228/Morphine) and control (No drugs) in any of the measurements (PAIN, LIMIT) except THRESH with the twitch and tetanus test. Conclusions: The data suggests that HP228 is an analgesic, but it does not appear to interact with morphine in an additive manner.