• Archives of Plastic Surgery
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• v.38 no.5
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• pp.649-654
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• 2011

Purpose: Split-or full-thickness skin grafts are used to reconstruct palmar skin and soft tissue defects after trauma or to release burn scar contracture on the hand. Glabrous skin defects should be substituted with similar skin to preserve function and aesthetics. The authors report their experiences with a technique that uses a full-thickness graft taken from glabrous skin on the ulnar edge of the palm for the reconstruction of soft tissue defects of the hand. Methods: During a three-year period from 2007 to 2010, 22 patients with burn scar contracture and 12 patients with post-traumatic skin defects on their hands were treated with full-thickness skin graft operations. The palmar skin and soft tissue defects after release of burn scar contracture or debridement of post-traumatic wounds were reconstructed with full-thickness skin grafts harvested from the ulnar border of their palms. All donor-site wounds were primarily closed. Results: The followup periods ranged from 3 to 25 months. Contractures of the hand were corrected without recurrence, and the grafts showed relatively good contour and color match to the adjacent fields. There were no reported complications such as significant color change or hypertrophic scarring. The grafted skin showed an average 5.9 mm static two-point discrimination obtained in fingertip reconstruction cases, indicating satisfactory reinnervation. Conclusion: Glabrous full-thickness grafts harvested from the palmar ulnar border is a very useful way of reconstructing soft tissue defects on hands, including fingertips, for function restoration, favorable aesthetic results, and low donor-site morbidity.

• Korean Journal of Oriental Medicine
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• v.5 no.1
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• pp.81-100
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• 1999

The result from the research on the disease classifications of the traditional medicine in China, Japan, Taiwan, and North Korea are followings: 1. It is remarkable that China has two different classifications. One is of the diseases named by western medicine and the other is of the syndromes compounded with parts, characters, and pathology of the diseases. The Traditional Chinese Medicine has 615 codes for diseases in 7 departments, and 1684 codes for syndromes. It seems that they have tried to match each disease named by the traditional chinese medicine to each one named by western medicine. But, they have left the diseases impossible to be equivalent to the ones in western medicine themselves and used the same codes of western medicine when the diseases are the same ones in western medicine. 2. In Taiwan, they try to connect the diseases named by the traditional medicine to the ones named by western medicine based on ICD-9. But, they did not attempt to classify the diseases of the traditional medicine by its own ways. The names of diseases in Taiwan medicine include both diseases and syndromes. It is limited to name syndromes by the traditional medicine. And, Taiwan medicine follows ICD in naming injuries. 3. Japan has not got the disease classification for the causes of death, but only the Japanese disease classification for the causes of death, a translation 'The international disease classification for the causes of death. Therefore, The diseases named by traditional medicines are excluded in the public medicine by some Japanese medicines which diagnose through the western medicine and treat by Wa Kang medicine. 4. I can't find out the data over the disease classification for the causes of death by traditional medicine in North Korea. Instead, I can refer to case histories in which differentiation of symptoms and signs and points about them by traditional medicine and the final diagnoses and report about examination by the western medicine has been recorded. In conclusion, It is a distinctive feature that they connect the diseases and the syndromes by the traditional medicine to the ones by the western medicine, and don't tell the diseases from the syndromes.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.944-949
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• 2021

Objective : The stability is an important factor to decide the treatment plan in thoracolumbar burst fracture patients. Patients with an unstable burst fracture generally need operative management. Decrease in vertebral body height, local kyphosis, involvement of posterior column, and/or canal compromise are considered important factors to determine the treatment plan. On the other hand, in thoracolumbar injury classification system (TLICS), surgery is recommended in patients with TLICS of more than 5 points. The purpose of this study was to apply the TLICS score in patients with thoracolumbar burst fractures and to distinguish the differences of treatment plan on burst fracture. Methods : All patients, diagnosed as a thoracolumbar burst fracture between January 2006 and February 2019 were included in this study. Unstable thoracolumbar burst fracture was defined as burst fracture with neurologic deficit, three-column injury, kyphosis over 30 degrees, decrease of anterior body height over 40 percent and canal comprise more than 50%. TLICS score was measured with morphology, neurological involvement and posterior ligamentous complex integrity. The existence of instability was compared with TLICS score. Results : Total 233 patients (131 men, 102 women) were included in this study. In Denis classification, 51 patients (21.9%) diagnosed as stable burst fracture while 182 patients (78.1%) had unstable burst fracture. According to TLICS, 72 patients (30.9%) scored less than 4, while 161 patients (69.1%) scored 4 or more. All the patients with stable burst fracture scored 2 in TLICS. Twenty-one patients (9.0) scored 2 in TLICS but diagnosed as unstable burst fracture. Thirteen patients had over 40% of vertebra body compression, four patients had more than 50% of canal compromise, three patients had both body compression over 40% and kyphosis over 30 degrees, one patients had both body compression and canal compromise. Fifteen patients presented kyphosis over 30 degrees, and three (20%) of them scored 2 in TLICS. Seventy-three patients presented vertebral body compression over 40% and 17 (23.3%) of them scored 2 in TLICS. Fifty-three patients presented spinal canal compromise more than 50%, and five (9.4%) of them scored 2 in TLICS. Conclusion : Although the instability of thoracolumbar burst fracture was regarded as a critical factor for operability, therapeutic strategies by TLICS do not exactly match with the concept of instability. According to the concept of TLICS, it should be reconsidered whether the unstable burst fracture truly unstable to do operation.