We surveyed the wearing characteristics of hip protectors. The problems of existing hip protectors were identified and the directions for improvement were presented. The evaluation of wearing characteristics was conducted on the 100 elderly women (60 to 85 years) with 5 types of hip protector. The questionnaire was composed of history and characteristics on falling, hip protector acceptance, preference, use characteristics and improvement requirements. The result of wearing characteristic evaluation indicated that 52% of the subject experienced falling in winter. Incidents resulting from falling occurred: outdoors (74.5%), bathroom (10.9%), and kitchen (5.5%). Body parts to be protected were in several areas: 35.6% for lumbar, 26.9% for hip joint, and 15% for hip bone. Participants prefer a belt B type design at a rate of 56.9% because it provided a sense of stability by clinging to the body and upholding the waist. Belt B type was the most appropriate in terms of fit, allowance, mobility, and design except pad thickness. To reduce the risk of hip fracture, hip protector needs to be designed in consideration of user's type of fall and body shape. The pattern and size of a hip protector has to be improved in regards to the amount of discomfort. An objective evaluation is needed for the ergonomic design of a hip protector based on and analysis of 3D body image of the elderly and the shock-absorbing quality of pad.
Metal fume fever has been known as an occupational disease is induced by intense inhalation of fresh metal fume with a particle size smaller than $0.5{\mu}m\;to\;1{\mu}m$. The fumes originate from heating metals beyond their boiling point, as happens, for example, in welding operations. Oxidation usually accompanies this process. In most cases, this syndrome is due to exposure to zinc oxide fumes; however, other metals like copper, magnesium, cadmium, manganese, and antimony are also reported to produce such reactions. Authors report a case of metal fume fever suspected to be associated with copper fume inhalation. The patient was a 42-year-old male and was a smoker. He conducted inert gas tungsten arc welding on copper-coated materials without safety precautions such as a protective mask and adequate ventilation. Immediately after work, he felt metallic taste in his mouth. A few hours after welding, he developed headache, chilling sensation, and chest discomfort. He also complained of myalgia, arthralgia, feverish sensation, thirst, and general weakness. Symptoms worsened after repeated copper welding on the next day and subsided gradually following two weeks. Laboratory examination showed a transient increase of neutrophil count, eosinophilia, elevated erythrocyte sedimentation rate, and positive C-reactive proteinemia. Blood and urine copper level was also increased compared to his wife. Before this episode, he experienced above complaints several times after welding with copper materials but welding of other metals did not produce any symptoms. It was suggested that copper fume would have induced metal fume fever in this case. Further investigations are needed to clarify their pathogenic mechanisms.
Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.
Users are able to search and read interesting items and hence click hyperlink linked to the item which is detailed content unit such as menu, login, news, video, etc. Small screen like mobile device is very difficult to viewing all web contents at once. Browsing and searching for interesting items by scrolling to left and right or up and down is discomfort to users in small screen. Searching and displaying directly the item preferred by users can reduces difficulty of interface manipulation of mobile device. To archive it, web contents based on desktop will be segmented on a per-item basis which component unit of web contents. Most segment algorithms are based on segment method through analysis of HTML code or mobile size. However, it is difficult to extract item blocks. Because present web content is getting more complicated and diversified in structure and content like web portal services. A web content segment algorithm suggested in this paper is based on extracting item blocks is component units of web contents.
The reconstructive modalities for vaginal reconstruction include simple dilatation, skin graft, use of intestinal segments and various methods using flaps. However, skin grafting procedure is the most commonly used technique and the McIndoe procedure is a representative technique among skin grafting procedures. McIndoe procedure is easier, faster and has a lower morbidity compared to other techniques. However the conventional McIndoe procedure has several problems such as incomplete vestibule formation, excessive bleeding during dissection, possibility of recto-vaginal or urethro-vaginal fistula formation, late vaginal contracture and discomfort in wearing hard plastic mold for a long time after operation. To solve these problems, the authors modified the conventional McIndoe procedure in several perspectives. The undeveloped vestibule was incised with X-shaped mucosal incision between the urethral opening and posterior margin of the vestibule and deepened by blunt finger dissection to provide a sufficient diameter & length of the neovagina and to minimize bleeding. A sizable medium thickness split skin graft was harvested and wrapped over a roll gauze-filled condom mold. Applying multiple stab incision on the skin grafted condom mold, it was inserted into the prepared neovaginal canal. Distal margin of the skin graft was secured with tips of the mucosal flaps created by X-shaped vestibular incision to prevent accidental extrusion of the skin grafted mold. During last 15 years, we applied this modification to 20 vaginal agenesis patients and investigated results of the 12 patients who could be followed up serially including hematoma formation and skin graft survival rate, size, depth, presence of late contracture, appearance, comfortness, and hygiene of the neovagina. And they were compared with 8 patients of 20 patients who underwent conventional McIndoe procedures. The modified McIndoe procedure revealed lower complication rate, higher patient satisfaction and better functional results.
Oh, Tae Suk;Min, Kyunghyun;Song, Sin Young;Choi, Jong Woo;Koh, Kyung Suk
Archives of Plastic Surgery
/
v.45
no.3
/
pp.222-228
/
2018
Background The most common surgical treatment for paralytic lagophthalmos is the placement of a weight implant in the upper eyelid; however, this technique confers the risks of implant visibility, implant extrusion, and entropion. In this study, we present a new technique of placing platinum weight implants between the levator aponeurosis and inner septum to decrease such complications. Methods A total of 37 patients with paralytic lagophthalmos were treated between March 2014 and January 2017 with platinum weight placement (mean follow-up, 520.1 days). After dissecting through the orbicularis oculi muscle, the tarsal plate and levator aponeurosis were exposed. The platinum weights (1.0-1.4 g) were fixed to the upper margin of the tarsal plate and placed underneath the orbital septum. Results Five patients could partially close their eye after surgery. The average distance between the upper eyelid and the lower eyelid when the eyes were closed was 1.12 mm. The rest of the patients were able to close their eye completely. Three patients patient developed allergic conjunctivitis after platinum weight insertion, which was managed with medication. None of the patients complained of discomfort in the upper eyelid after surgery. Visibility or extrusion of the implant were observed in three patients. Conclusions Postseptal weight placement is a safe and reproducible method in both primary and secondary upper eyelid surgery for patients with paralytic lagophthalmos. It is a feasible method for preventing implant visibility, implant exposure, and entropion. Moreover, platinum is a better implant material than gold because of its smaller size and greater thinness.
Background The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Methods From April 2008 to August 2018, a total of 11 patients underwent contracture release and resurfacing surgery using TDAP flaps due to donor morbidity associated with RSA flaps. All affected donor sites were covered with a skin graft, the most common of which was a meshed split-thickness skin graft (six cases). Results Eight of the 11 patients (72.7%) suffered from pain and discomfort due to scar contracture, and seven (63.6%) complained of a depression scar. The donor sites were located 6.3±4.1 cm below the knee joint, and their average size was 140.1 cm2. After resurfacing using TDAP flaps, significant improvements were found in the Lower Extremity Functional Scale (LEFS) scores and the active and passive ranges of motion (AROM and PROM) of the knee joint. The LEFS scores increased from 45.1 to 56.7 postoperatively (P=0.003), AROM increased from 108.2° to 118.6° (P=0.003), and PROM from 121.4° to 126.4° (P=0.021). Conclusions Planning of RSA flaps should take into account donor site morbidity. If complications occur at the donor site, resurfacing surgery using TDAP flaps achieves aesthetic and functional improvements.
Ho Yoon Jeong;Taewoo Kang;Heeseung Park;Kyoung Eun Kim;Su Bong Nam;Ju Young Go;Seong Hwan Bae
Archives of Plastic Surgery
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v.51
no.1
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pp.62-66
/
2024
Gestational gigantomastia is characterized by the rapid growth of breasts during pregnancy. The treatment method of gestational gigantomastia is unclear; if the medical treatment is ineffective, surgery is considered. However, sufficient research on which method is best to perform breast reconstruction for the gestational gigantomastia patient has not yet been conducted. Our patient was young and had aesthetic needs; thus, we did not recommend modified radical mastectomy. However, it was difficult for the patient to consider active reconstruction using an implant or autologous tissue because of the expected complications and economic problems. The patient had a thin body shape and very large breasts compared with the trunk. Therefore, breast volume was not significantly required after reconstruction. Additionally, we expected that a considerable portion of skin would remain after mastectomy as a tubular-shaped breast. It was expected that the Goldilocks technique would be sufficient to meet the patient's volume needs. Therefore, we proceeded with total mastectomy and reconstruction using the Goldilocks procedure. No complications were recorded after the operation; most of the patient's discomfort was resolved, and the shape and size of the breasts were satisfactory.
Jeong, Seunghui;Lee, Seon Young;Eu, Sun Mi;Kim, Douk-Hoon;Lee, Eun-Hee
Journal of Korean Ophthalmic Optics Society
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v.14
no.4
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pp.65-69
/
2009
Purpose: Recently incidence of VDT syndrome has gradually increased as extensive use of computers. VDT syndrome reported by VDT workers include musculoskeletal disorder, neuropsychiatric disoders and eye symptoms such as eye strain, tired eyes, irritation and blurred vision. The environmental factors of VDT syndrome include electromagnetic waves, size, brightness and lighting of computer screen, height of a monitor and a worktable, working hours, kind of task, distance between screen and workers, indoor humidity and temperature, indoor air contamination and ventilation. In this study, we investigated the environmental factors related to body symptoms and health effects included in VDT syndrome. Methods: Study subjects were total 120 persons (54 male, 66 female) with age from 19 to 28. We surveyed the body symptoms and physical discomfort when doing an activity in a short distance such as reading book or paper, computer work. The questionnaire included main body symptoms, self-consciousness symptoms of eye, satisfaction of working environment, pain of the wrist when using keyboard and mouse. Results: Most of people (70%) felt physical pain from long time work of computer, paper, electrical apparatus. They mainly complained pain of neck and low back (57.1%), eye (45.2%) and head (31%). With the environmental factors, 78.3% of the subjects complaint pain of eye from inappropriate illumination. Most of the symptoms included 'eye fatigue'(38.3%), 'dryness of eye'(31.9%) and 'blurred vision'(23.7%). Subjects in this study complained discomfort of their chairs and most of them experienced pain in the wrist when using keyboard or mouse. Conclusions: When people use electrical apparatus or work with paper, people would get their eye fatigue and feeling of physical fatigue because of not harmonizing various environmental factors such as light, space, posture, worktable with theirselves. Therefore, workers should develop preventive method such as self-control of adequate break time to avoid fatigue while VDT work. Work environment should be changed to ergonomic design for optimal visual environment to prevent musculoskeletal disorder through constant research.
Park, Mi-Ran;Kim, Chang-Sun;Seo, Jee-Young;Son, Hyung-Dae;Rheu, Nam-Soo;Cho, Dong-Il
Tuberculosis and Respiratory Diseases
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v.44
no.6
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pp.1225-1233
/
1997
Background : Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. Method : All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL. Results : 1) CTL is most prevalent in young women between the age of 20~30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6%(p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%), other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most Common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%), fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). Conclusion : CTL is prevalent in women between the age of 20~40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.
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