• Title/Summary/Keyword: Plastic Surgery

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Review of 2010 Major Medical Decisions (2010년 주요 의료 판결 분석)

  • Lee, Jung-Sun;Seo, Young-Hyun;Yoo, Hyun-Jung
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.177-225
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    • 2011
  • Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It's shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it's not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

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Three-dimensional image analysis of the skull using variable CT scanning protocols-effect of slice thickness on measurement in the three-dimensional CT images (두개골의 3차원 영상 분석을 위한 전산화단층촬영 방법의 비교-상층 두께가 3차원 영상의 계측에 미치는 영향)

  • Jeong Ho-Gul;Kim Kee-Deog;Park Hyok;Kim Dong-Ook;Jeong Haijo;Kim Hee-Joung;Yoo Sun Koo;Kim Yong Oock;Park Chang-Seo
    • Imaging Science in Dentistry
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    • v.34 no.3
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    • pp.151-157
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    • 2004
  • Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0/sup TM/(Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons' two-sample test. Results: 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5mm, 10 in Helical 5mm, 5 in Conventional 7mm and 9 in Helical 7mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2mm in 19 line items of Conventional 3mm, 20 of Helical 3mm, 15 of Conventional 5mm, 18 of Helical 5mm, II of Conventional 7mm and 16 of Helical 7mm. Conclusion: Considering image quality and patient's exposure time, scanning protocol of Helical 5mm is recommended for 3D image analysis of the skull in CT.

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Drug Adsorption Behavior of Polyolefin Infusion Tube Compared to PVC and PU (Non-PVC(폴리올레핀) 수액용 튜브 내면에서의 약물흡착 거동 - PVC 및 PU 수액튜브와의 비교)

  • Park, Kang Hoon;Park, Chang Kyu;Park, Jong;Jeon, Seungho;Bang, Sa-Ik;Kim, Ji-Heung;Chung, Dong June
    • Polymer(Korea)
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    • v.38 no.3
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    • pp.333-337
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    • 2014
  • PVC (polyvinyl chloride) intravenous fluid bags and tubes that contain DEHP (diethylhexyl phthalate) as a plasticizer have several associated disadvantages for intravenous injections. We investigated the drug absorption behaviors on the inner surface of an infusion tube that consisted of commercialized PVC/PU (polyurethane). We developed a non-PVC (polyolefin) tube in order to improve the efficacy of this drug administration method. We prepared four types of non-PVC (polyolefin) infusion tubes using a polyethylene (PE), polypropylene (PP), syndiotactic 1,2-polybutadiene (PB), and styrene-ethylene (SE) copolymer elastomers were prepared using a single screw extruder. The four types of manufactured non-PVC (polyolefin) infusion tubes had good mechanical properties that were equivalent to PVC tube properties. The four types of prepared non-PVC (polyolefin) infusion tubes also prohibited drug absorption when compared to the commercialized PVC and PU tubes. Therefore, based on the results of this study, prepared non-PVC (polyolefin) tubes are good candidates for infusion because they prevent drug absorption and the release of DEHP.

Esthetic Root Coverage for Gingival Recession (심미적인 결과를 얻기 위한 치근 피개술)

  • Ahn, MyungHwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.26 no.1
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    • pp.4-16
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    • 2017
  • In dental esthetics, soft tissue plays an important part, probably very large portion of it. A clear understanding of the periodontal tissues and its management around teeth and implants help us to develop concepts for a modern dental treatment that addresses the needs of demanding patients in regard of esthetics and durability. When we talk about esthetic, we can say that one of the most important element is a harmonization with gingiva (soft tissue) called 'Pink Esthetic' As for the pink esthetics, gingival line(contour) takes most of the influence on esthetic result; it consists of labial gingival level, interproximal papilla height, and a line that connects them. In the gingival recession, labial gingival level and gingival contour move to the apical portion, and the root area is exposed. It leads to the unesthetic result. Root coverage technique is classically used to treat gingival recession (marginal tissue recession) of natural teeth. It is an essential technique on periodontal plastic surgery part. It is also a very useful technique to recover soft tissue problems in implant dentistry. So, root coverage technique must be mastered for a good implant esthetic result. The general overview of root coverage procedures will be discussed with step by step explanation to get more esthetic result.

c-fos mRNA Expression in the Vestibular System following Hypergravity Stimulation in Rats

  • Jin Guang-Shi;Lee Jae-Hyo;Lee Jae-Hee;Lee Moon-Young;Kim Min-Sun;Jin Yuan Zhe;Song Jeong-Hoon;Park Byung-Rim
    • The Korean Journal of Physiology and Pharmacology
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    • v.11 no.1
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    • pp.1-7
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    • 2007
  • Altered environmental gravity, including both hypo- and hypergravity, may result in space adaptation syndrome. To explore the characteristics of this adaptive plasticity, the expression of immediate early gene c-fos mRNA in the vestibular related tissues following an exposure to hypergravity stimulus was determined in rats. The animals were subjected to a force of 2 g (twice earth's gravity) for 1, 3, or 12 h, and were examined poststimulus at 0, 2, 6, 12, and 24 h. RT-PCR (reverse transcription polymerase chain reaction) and real-time quantitative RT-PCR were adopted to analyze temporal changes in the expression of c-fos mRNA. The hypergravity stimulus increased the expression of c-fos mRNA in the vestibular ganglion, medial vestibular nucleus, inferior vestibular nucleus, hippocampus, cerebellum, and cortex. The peak expression occurred at 0 h poststimulation in animals stimulated with hypergravity for 1 h, and at 6 h poststimulus in those stimulated for 3 h. In contrast, those stimulated for 12 h exhibited dual peaks at 0 and 12 h poststimulus. Bilateral labyrinthectomy markedly attenuated the degree of c-fos mRNA expression. Glutamate receptor antagonist also dramatically attenuated the degree of c-fos mRNA expression. These results indicate that expression of c-fos mRNA in response to hypergravity occurs in the vestibular related tissues of the central nervous system, in which peripheral vestibular receptors and glutamate receptors play an important role. The temporal pattern of c-fos mRNA expression depended on the duration of the hypergravity stimulus.

The effect of hospital workers cosmeceutical cosmetics product selection on marketing communications (병원종사자의 코스메슈티컬화장품에 대한 제품선택이 마케팅커뮤니케이션에 미치는 영향)

  • Kang, Yu-Na;Lee, In-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.88-98
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    • 2017
  • The purpose of this study is to investigate the effect of product selection of hospital workers cosmeceutical cosmetics on marketing communication among hospital workers who use cosmeceutical cosmetics that have emerged in line with the recent growing medical skin care field.Coping with complaints from consumers who buy cosmeceutical cosmetics in hospitals where cosmeceutical cosmetics are mainly used and sold, and minimizing the influence of negative issues will potentially strengthen consumer relationships. The study was conducted on 520 hospital workers who use cosmeceutical cosmetics in hospitals (dermatology, plastic surgery, women's clinic, and other hospitals) in Seoul, Gyeonggi and Incheon. A total of 502 questionnaires were used for the final analysis. The data analysis consisted of Cronbach's alpha, one-way ANOVA, exploratory factor analysis and Duncan test. Correlation analysis was performed to investigate the correlation between variables, and regression analysis was conducted to test hypotheses. The study results revealed that when choosing cosmetic cosmetics, marketing communication is influential. Especially, product value, quality, and price factors strongly affect marketing communication. This shows that we value the product and quality the most and we want a reasonable price. Considering this, we will pursue differentiated products only from cosmeceutical cosmetics and provide them as basic data necessary for securing potential customers and increasing the sales of cosmeceutical cosmetics in accordance with the changing trends.

Surgical Treatment of Squamous cell Carcinomas Arising in Scalp Burn Wounds - Two Case Reports - (화상 후 두피에 생긴 편평 상피세포 종양에 대한 증례 보고 - 증례보고 -)

  • Kim, Kang San;Hwang, Hyung Sik;Kwon, Heum Dai;Moon, Seung Myung;Oh, Suk Jun;Choi, Sun Kil
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.52-56
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    • 2007
  • Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

Locking horizontal mattress suture as the alternative closure method for scalp lacerations difficult to suture with staple (두피 봉합기로 봉합하기 어려운 두피 열상에 시행한 잠금 수평 매트리스 봉합법의 유용성 관찰 연구)

  • Sah, Seung Woo;Seol, Seunghwan;Lee, Woon Jeong;Woo, Seon Hee;Kim, Dae Hee;Lee, June Young;In, Sangkook;Kim, Bonggyeom
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.649-655
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    • 2018
  • Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

Guidelines for dental clinic infection prevention during COVID-19 pandemic (코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인)

  • Kim, Jin
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

Perioperative stress prolong post-surgical pain via miR-339-5p targeting oprm1 in the amygdala

  • Zhu, Yi;Sun, Mei;Liu, Peng;Shao, Weidong;Xiong, Ming;Xu, Bo
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.423-432
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    • 2022
  • Background: The decreased expression of mu-opioid receptors (MOR) in the amygdala may be a key molecular in chronic post-surgical pain (CPSP). It is known that miR-339-5p expression in the amygdala of a stressed rat model was increased. Analyzed by RNAhybrid, miR-339-5p could target opioid receptor mu 1 (oprm1) which codes MOR directly. So, the authors hypothesized that miR-339-5p could regulate the expression of MOR via targeting oprm1 and cause the effects to CPSP. Methods: To simulate perioperative short-term stress, a perioperative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception rat model was built. A pmiR-RB-REPORTTM dual luciferase assay was taken to verify whether miR-339-5p could act on oprm1 as a target. The serum glucocorticoid level of rats was test. Differential expressions of MOR, GFAP, and pERK1/2 in each group of the rats' amygdala were tested, and the expressions of miR-339-5p in each group of rats' amygdalas were also measured. Results: Perioperative stress prolonged the recovery time of incision pain. The expression of MOR was down-regulated in the amygdala of rats in stress + incision (S + IN) group significantly compared with other groups (P < 0.050). miR-339-5p was up-regulated in the amygdala of rats in group S + IN significantly compared with other groups (P < 0.050). miR-339-5p acts on oprm1 3'UTR and take MOR mRNA as a target. Conclusions: Perioperative stress could increase the expression of miR-339-5p, and miR-339-5p could cause the expression of MOR to decrease via targeting oprm1. This regulatory pathway maybe an important molecular mechanism of CPSP.