• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.39-46
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• 1997

The methods of clinical applications of the foot as a free-flap donor site includes microvascular toe-to-finger transfer, free neurovascular flap transfer, first web space flap transfer, and osteocutaneous free flap transfer. We have evaluated the results of treatment for 35 patients to be undergone a microvascular reconstructive procedure with the foot as a donor site from January 1982 to June 1996. The performed operations were 16 cases of thumb reconstruction with wrap around procedure, 3 cases of tenocutaneous flap transfer, 10 cases of dorsalis pedis flap transfer, 2 cases of first web space free flap and 4 cases of toe-to-finger transfer. The follow up study was 69 months in average. Regarding to the various donor sites, morbidity was divided into five different categories: Cosmesis, Functional loss, Sensory loss, Wound complication, and Pain. According to the results of examination(35 patients), the results was excellent(25), good(9), fair(1), and poor(0). Among the categories, morbidity was higher at cosmesis. The patients under 50 years were better outcome. Among the operative methods from the foot as a donor site, thumb reconstruction with wrap around procedure showed poorest outcomes. So, We conclude that the foot as a free flap donor site is a good source for the microvascular reconstructive surgery. But, Preoperative donor site evaluation, adequate operative technique and post operative management are essential to decrease the morbidity of donor site.

• Journal of Korean Physical Therapy Science
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• v.30 no.4
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• pp.9-16
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• 2023

Background: Bedridden patients and disabled persons need help from a guardian or caregiver even in performing simple activities of daily living. In particular, for body transfer of them, the use of a transfer lift has been recommended. However, the devices currently in use have limitations in terms of support according to the individual's characteristics. This study aimed to develop a transfer lift device utilizing the patients' body-fitting sling equipped with an air tube inside the sling. In addition, we have conducted usability tests to examine the safety, effectiveness, and satisfaction with this device. Design: This study conducted usability tests with 10 healthy adults. Methods: Customized sling lifts are generally floor-based devices that consisted of a sling that holds the patient's body and a lift that moves the sling to the desired position. One characteristic feature of the device is an air tube, which is used on the sling to allow the patient's body can be adjusted. A usability test was performed in terms of the operators, who operated the device to transfer the patients. Ten operators tried the device and tested its usability. Results: The mean of 10 question for Questions was 4.18. Conclusion: The device can be useful in the advance- ment and commercialization of customized sling lifts, to ensure the safe and efficient transfer of persons with disabilities.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.229-236
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• 2015

Background: Twenty-six patients (12 male and 14 female) with symptomatic scapular winging caused by serratus anterior dysfunction were managed by split pectoralis major tendon transfer (sternal head) with autogenous hamstring tendon augmentation from 1998 to 2006. Methods: Twenty-five patients showed positive results upon long thoracic nerve palsy on electromyography. The mean duration of symptoms until surgery was 48 months (range, 12-120 months). Four patients had non-traumatic etiologies and 22 patients had traumatic etiologies. On follow-up assessment for functional improvement, a Constant-Murley score was used. Twenty-one patients were completely evaluated, while five patients who had less than 12 months of follow-up were excluded. Results: Pain relief was achieved in 19 of the 21 patients, with 20 patients showing functional improvement. The pain scores improved from 6.0 preoperatively to 1.8 postoperatively. The mean active forward elevation improved from $108^{\circ}$ (range, $20^{\circ}-165^{\circ}$) preoperatively to $151^{\circ}$ (range, $125^{\circ}-170^{\circ}$) postoperatively. The mean Constant-Murley score improved from 57.7 (range, 21-86) preoperatively to 86.9 (range, 42-98) postoperatively. A recurrence developed in one patient. Of the 21 patients, ten had excellent results, six had good results, four had fair results, and one had poor results. Conclusions: Most patients with severe symptomatic scapular winging showed functional improvement and pain relief with resolution of scapular winging.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.52-57
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• 1995

The authors have reviewed 19 patients of brachial plexus injury who treated by operative methods at Department of Orthopedic Surgery, Korea University Hospital during the period from January 1989 to February 1994. All of these patients were followed up more than one year and following results were obtained. 1. The whole arm type injury was most common(7 of 19 patient) and supraclavicular lesion(15 of 19 patient) was more dominant than infraclavicular lesion(4 of 19 patients). 2. The neurorrhaphy, nurolysis, nerve grafting, and neurotization were performed for the primary neural surgery and secondary reconstructive procedure consist of musculotendinous transfer and free muscle transfer with neurotization. 3. The followed up period was from one year to four years and six months, average being two years and five months. 4. We have obtained satisfactory results in 12 patients among 19 patients.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.7-11
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• 2001

Purpose : To evaluate the neurologic abnormalities in the donor limb after contralateral C7 transfer in brachial plexus injury. Materials and Methods : From August 1996 to December 1999, five patients with brachial plexus injury were treated with contralateral C7 nerve root transfer. The average follow up was 16 months(range, 5 to 36 months). The clinical findings were assessed using the British Medical Research Council Grading System, and also measured grip power, pinch power of hand and two point discrimination of the fingers. Results : We had no difference in shoulder abduction and elbow flexion after contralateral C7 transfer. The grip and pinch strength were recovered within 4weeks. Sensory loss occurred in all patients and was noted to be more severe on index and middle finger. Four patients recovered within 2 weeks, one continued till one year. Subjective numbness and pain on percussion minimally persisted until last follow-up. Conclusion : The division of the C7 nerve root resulted in minimal and temporary functional deficit in the donor upper limb.

• Archives of Reconstructive Microsurgery
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• v.23 no.1
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• pp.1-7
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• 2014

Purpose: Recent studies have reported on application of fibrin glue composed of fibrinogen and thrombin to nerve anastomosis, which can be another candidate for vessel anastomosis. However, no research regarding the risk and effectiveness of thrombin in microvascular free tissue transfer has been reported. Therefore, the aim of study is to determine the risk and effectiveness of thrombin on microvascular free tissue transfer through clinical cases. Materials and Methods: Twenty-five patients underwent free flap reconstruction for soft tissue defect or bone exposure in our institute from March 2011 to February 2014. In the group using thrombin, dissolved powder thrombin (5,000 IU/amp) was mixed with 10 mL normal saline. Saline mixed with thrombin was applied on the flap, recipient, and around vessel anastomosis. In the control group, free flap was performed using the same method, except using thrombin. We analyzed the results between the two groups. Results: All flaps survived. The group using thrombin included 14 patients and the control group included 11 patients. Hematoma was found in two cases, respectively, in each group. The group using thrombin showed lower incidence of hematoma than the control group. No difference in survival rate of the flap was observed between the thrombin group and the control group. Conclusion: Results of this study showed that use of saline mixed with thrombin in free tissue transfer may be safe and effective for prevention of hematoma formation in the recipient site.

• Clinical and Experimental Reproductive Medicine
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• v.51 no.1
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• pp.85-90
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• 2024

Objective: The purpose of this study was to compare fresh and frozen-thawed euploid blastocyst transfer protocols following preimplantation genetic screening (PGS) in cases of advanced maternal age. Methods: A total of 330 patients were examined retrospectively. PGS was performed on the embryos of 146 patients for whom fresh transfers were chosen. In contrast, frozen-thawed euploid single embryo transfer (ET) was selected after PGS for 184 patients, and their embryos were vitrified. The percentage of euploid embryos and rates of implantation, pregnancy, and pregnancy continuity, as well as clinical and biochemical abortion rates, were compared. Results: The numbers of retrieved oocytes, metaphase II oocytes, and fertilized ova were greater in the frozen-thawed group. The percentages of euploid embryos were comparable between the fresh and frozen-thawed groups (32% vs. 34.8%, respectively). The rates of implantation (46.6%vs. 62.5%), pregnancy (50% vs. 66.8%), ongoing pregnancy (38.4% vs. 53.8%), and live birth percentage (37.0% vs. 53.8%) were significantly higher in the frozen-thawed group. However, no significant differences were found in the clinical and biochemical abortion rates. Conclusion: The use of frozen-thawed single euploid ET is associated with increased implantation and pregnancy rates compared to fresh single euploid ET with PGS.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.25-30
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• 2011

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.12-23
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• 2020

Purpose : This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods : From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results : One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN- and physician-led transfers. Conclusions : Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS.

• Journal of Digital Convergence
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• v.19 no.4
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• pp.467-475
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• 2021

Purpose: When a patient with acute deterioration occurs in a ward, the decision to transfer to intensive care unit (ICU) is critical to improve the patient's outcomes. However, when available ICU resources limited, it is difficult to determine which of the deteriorating ward patients to transfer to the ICU. Therefore the purpose of this study was to identify risk factors in predicting deteriorating ward patients transferred to intensive care unit (ICU). Methods: We reviewed retrospectively clinical data of 2,945 deteriorating ward patients who referred medical emergency team. Data were analyzed with multivariate logistic regression. Results: The solid cancer that diagnosed at hospitalization (odds ratio[OR] 0.39; 95% confidence interval [CI] 0.32-0.47), when the cause of deterioration was respiratory problem (1.51; 95% CI 1.17-1.95), high MEWS (1.22; 1.17-1.28) and SpO2/FiO2 score (2.41; 2.23-2.60) were predictive of ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.