• Title/Summary/Keyword: Plastic Surgery

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Investigation of Factors Contributing to Childhood Soft-Tissue Injuries in the Face (소아의 안면 연부조직 손상에 관한 연구)

  • Sim, Mi-Jung;Sohn, In-A
    • Journal of Digital Convergence
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    • v.11 no.8
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    • pp.219-225
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    • 2013
  • The purpose of this study was to retrospectively investigate the contributing factors in facial soft tissue injuries among children. A record-based analysis was carried out on 126 patients with facial lacerations who visited I hospital in the dept of plastic surgery from April 2010 to May 2011. Through all age group showed a significant difference in incidence rate for male and female.(p<.05). Overall, 49% of injuries occurred outdoors and the most frequent cause of injury was slip-down (42%), followed by being struck (40%). In general, the frequency of injuries peaked summer(30.2%) and increased between 12pm and 4pm. 105 patients (83.3%) arrived at the emergency room within an hour. The forehead(26%) was the most commonly injured area. The depth of soft tissue injuries was mostly subcutaneous(54%), and 1~2cm was the length of injury with the highest incidence(46%). Most children (40%) needed local anesthesia and only 4 children (1.53%) suffered associated fractures. Facial injuries require special attention because of their potential threat in inducing permanent scar or disfigurement. For the safety of children, the preventive measures to reduce facial soft tissue injuries must be improved.

Development of Case Management System and Analysis of Economic Feasibility under the Fee-For-Service Reimbursement (행위별 수가 지불제도 하에서의 사례관리시스템 개발 및 경제성 분석)

  • Choi, Mi Young;Chae, Young Moon;Tark, Kwan Chul;Kim, In Suk;Chun, Ja Hae
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.46-60
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    • 2004
  • Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

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Rapid canine retraction in a Class II bialveolar protrusion case using a lingually extended distraction screw (제II급 치조 전돌 환자에서 설측 견인 장치를 이용한 급속 견치 견인술)

  • Ahn, Kwang-Seok;Joo, Euk;Park, Ju-Young;Ryu, Young-Kyu;Cha, In-Ho;Lee, Kee-Joon
    • The korean journal of orthodontics
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    • v.36 no.4
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    • pp.308-320
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    • 2006
  • Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.

Alteration in plasma chemokine profile in a high-fat diet-induced obesity mouse model (고지방식이로 비만을 유도한 생쥐에서 혈장 케모카인 발현 변화)

  • Kim, Dong-Hwan;Cho, Jeong Min;Seo, Min Joon;Lim, Ju Hyun;Bae, Hae-Rahn
    • Journal of Nutrition and Health
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    • v.51 no.5
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    • pp.369-378
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    • 2018
  • Purpose: Obesity is associated with a dysregulation of metabolic balance and is regarded as a low grade chronic inflammation. Western-style diet and physical inactivity are leading causes of obesity. This study examined the profiles of forty plasma cytokines and chemokines at the same time in the early stages of high-fat diet-induced obesity using a mouse model. Methods: A total of 30 male CD1 mice, 12 ~ 14 weeks of age, were enrolled. The mice were fed a high-fat diet for 6 weeks to induce obesity. The plasma glucose and triglyceride concentrations were measured using a hexokinase colorimetric assay kit and a serum triglyceride determination kit, respectively. The relative levels of multiple cytokines and chemokines in the plasma were determined using a mouse cytokine array kit. Results: The mice exhibited significant weight gain after 6 weeks of a high-fat diet. The genital fat depot was enlarged along with an increase in the number and the mean size of white adipocytes as early as 4 weeks after a high-fat diet. In addition, the plasma glucose and triglyceride levels increased significantly after 4 weeks of a high-fat diet. Cytokine array analysis revealed a remarkable increase in the expression of both CXCL12 and CXCL13, whereas the proinflammatory cytokines remained low after 4 weeks of a high-fat diet. Conclusion: A significant increase in plasma levels of CXCL12 and CXCL13 was observed after 4 weeks of a high-fat diet, which might induce the migration of B lymphocytes, T lymphocytes, and monocytes from the blood to expanding adipose tissue or fat associated lymphoid clusters, playing a key role in adipose tissue remodeling and local immunity during the early stages of high-fat diet-induced obesity.

Clinical and Physical Characteristics That Affect Apnea-Hypopnea Index in Suspected Obstructive Sleep Apnea Patients : The Preliminary Study (폐쇄성수면무호흡증 의심환자에서 무호흡저호흡지수에 영향을 주는 임상적 신체적 요인 : 예비연구)

  • Kang, Seung-Gul;Shin, Seung-Heon;Lee, Yu Jin;Jung, Joo Hyun;Kang, Il Gyu;Park, Insook;Kim, Peter Chanwoo;Ye, Mi Kyung;Hwang, Hee Young;Kim, Seon Tae;Park, Kee Hyung;Kim, Ji-Eun
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.54-60
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    • 2013
  • Objectives The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. Methods We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. Results A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). Conclusions The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.

Study of matching user operation name and operation classification code (ICD-9-CM) (Through OCS program use facilitation at operating room) (사용자 수술명과 수술분류 code (ICD-9-CM) 일치율 향상에 관한 연구 (수술실 OCS program 사용 활성화를 통하여))

  • Choi, Hyang-Ha;Kim, Mi-Young;Kim, Do-Jin;Yu, Ji-Won;Chang, Jung-Hwa;Park, Su-Jung;Park, Jae-Sung
    • Quality Improvement in Health Care
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    • v.12 no.1
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    • pp.104-112
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    • 2006
  • Background : The necessity of unify and standardize codes used at hospital has been emphasized since OCS (Order Communicating System) was adopted. Therefore, the purpose of this study were to standardize operation code by continuous training of the ICD-9-CM code that is used as standard code in OCS program at operating room. Method : In 400 operation data, operation code entered in OCS program at operating room was compared to operation name recorded in medical record. In addition, a matching rate between input data of operation code by medical record department and computing input data of operation code in 3,710 cases was compared for each department. User operation name and operation code were matched and major diagnosis by operation department and operation name were also matched. Results : User operation name was reflected in operation classification code in detail, and operation code entered on user was registered. Input rate and matching rate of operation code were gradually improved after improvement activity. In particular, a matching rate was high at ophthalmology where operation name is segmented. Plastic surgery and orthopedics with a lot of emergency operation and comprehensive operation name show low input rates. Conclusions : As the medical field makes progress in computerlization, awareness of information exchange and sharing becomes higher. Among codes to classified medical institution, codes related to surgical operation are all different by user of hospital and department. Computerlization and standardization is essential. And when efforts of standardization continue in alliance with individual hospital and institution, initiative of preparing medical policy data at a national level will be accelerated.

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Histological Evaluation of Bioresorbable Threads in Rats (랫드에서의 생분해성 매선요법에 대한 조직학적 분석)

  • Lee, Chang Gun;Jung, Jaeyun;Hwang, Samnoh;Park, Chan Oh;Hwang, Soonjae;Jo, Minjeong;Sin, Min Hi;Kim, Hyun Ho;Rhee, Ki-Jong
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.217-224
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    • 2018
  • Thread lifting has become popular as a minimally invasive technique for facial rejuvenation. Commercially available threads are composed of poly-L-lactic acid (PLLA), polycaprolactone (PCL), or polydioxanone (PDO). However, the histological changes that occur in response to implanted threads are unclear. The aim of this study was to evaluate histological changes that occur in response to implantation with three types of bioresorbable threads (PLLA, PCL, PDO) in rat skin. PLLA, PCL and PDO threads were implanted in the dorsal skin of Sprague Dawley rats and tissue samples were harvested 2, 4, 8 and 12 weeks post-implantation. To evaluate histologic changes induced by bioresorbable face-lifting threads, tissue samples were stained with hematoxylin & eosin, Masson's trichrome stain and Herovici's collagen stain. All three threads induced neocollagenesis of type 3 collagen in the rat skin. The amount of collagen induced by the threads was dependent on the thread surface area. The PDO cavern-type thread was most effective in inducing neocollagenesis due to its extensive surface area. Our results suggest that type 3 collagen induced by bioresorbable threads depends on the thread surface area to uphold the dermis and contributes to facial rejuvenation.

Assessment of Damages for Non-pecuniary Loss and Compensation for Damages in Medical Accidents - Overview for Cases of Medical Injury Relief in Korea Comsumer Agency - (의료사고의 손해배상과 위자료 산정 -한국소비자원 의료피해구제 사례들의 일별-)

  • Kim, Kyoung Reay;Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.179-214
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    • 2012
  • There are two opinions on the legal characteristics of damages for non-pecuniary loss, a private sanctions theory and complementary function of damages for non-pecuniary loss, briefly. There is a close connection between the legal characteristics and the function of damages for non-pecuniary loss. The functions of damages for non-pecuniary loss are consist of satisfaction, prevention( sanctions) and complementation. Several cases of medical injury relief reported to Korea Comsumer Agency are categorized as follows, 1) cases of death after having an operation, 2) diagnosed with disability after a medical accident, 3) extended damages happening related to delayed diagnosis, 4) et cetera(a plastic surgery, a treatment with oriental medicine), and the damages for non-pecuniary loss in respect to each cases are examined. In the case of occurring death or disability, Korea Comsumer Agency has set up guidelines for assessment of damages for non-pecuniary loss by classifying into major and collateral violation for a duty of care. Furthermore, the damages for non-pecuniary loss in the case of all sorts of cancers, are assessed in accordance with the degree of responsibility subsequent to dividing cancer into good and poor prognosis. When it comes to a complementary function of damages for non-pecuniary loss in the actual work, it is hard to assess the damages as it is difficult to objectify non-pecuniary loss, such as emotional distress. Though compensation for damages is major legal characteristics of consolation money, preventing a damage(private sanctions) through consolation for a victim or sanctions against an assailant also has great significance. Therefore, it is necessary to approach flexibly for mutual agreement by considering specialty( concrete facts) of individual issue thoroughly. If considering this aging society that limits the possible age for work to 60 years old, it is needed to have a complementary function of consolation money in mind not to make it less meaningful for victims due to small sum of consolation money.

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The Changing Patterns of Antibiotic Susceptibility for Acinetobacter baumannii in Pediatric Burn Patients (소아 화상환자에서 배양된 Acinetobacter baumannii에 대한 항생제 감수성 양상의 변화)

  • Lee, Sang-Min;Lee, So-Yeon;Kim, Young-Ho;Lee, Kyu-Man;Jang, Young-Chul;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.146-151
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    • 2008
  • Purpose : Multidrug-resistant Acinetobacter baumannii (A. baumannii) is recognized to be the most difficult pathogen to control and treat in pediatric burn centers. We analyzed the antibiotic susceptibility pattern of A. baumannii in our pediatric burn intensive care unit during the past 7 years. Methods : We retrospectively evaluated 56 patients (105 samples) under the age 15 years and who were infected with A. baumannii between January 1999 and December 2005. Results : Fot the 56 patients, the ratio of males to females was 1.15:1 and the median age was 48.3 months. The sites of 105 isolates were wounds (65%), sputum (20%), blood (6 %), cutdown tips (5%), endo-tip tubes (2%) and urine (2%). A. baumannii presented yearround. The annual antimicrobial resistance rate increased and the multidrug resistant rate for two or more antibiotics was 93.33%. For 3 patients in whom resistance emerged, the interval period between the susceptible and resistant strains after antibiotic use was a mean of 10 days. The A. baumannii isolated from blood were all multi-drug resistant pathogens. Conclusion : Multidrug resistance of A. baumannii is increasing. Strict infection control guidelines and active surveillance are needed for the prevention and treatment of A. baumannii in hospitals.

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The legal status of the breast in assessing physical disability (신체장애 평가에서 유방의 법적 지위 - 장기 해당 여부, 수유장애, 노동력상실에 대하여 -)

  • Kim, Bong Kyum
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.265-295
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    • 2017
  • Breast tissue is composed of skin, mammary gland(including lactiferous duct), subcutaneous fat layer. The anatomical position is on the anterior chest wall(the outside of the chest cavity) but not on the inside of the thorax. Therefore, when the internal organs in the thoracic cavity are defined and expressed as 'organs' and the internal organs of each are labeled for a long time, for the breast located outside the thoracic cavity, it is thought that there is considerable difficulty in defining and recognizing the breast tissue as organs. For this reason, it is necessary to discourage the controversy over whether or not the breast is contained in the chest(or intra-thoracic cavity). In order to completely exclude it, it is assumed that the "chest-abdomen" can be called the "intra-thoraxic or intra-abdominal." But it is difficult to change the terms in various laws and regulations, I think that it would be necessary to insert only the clue clause "Breasts are excluded" in the detailed criteria for grading. In order to include it, it is necessary to change the terms of the ordinance or to say that the breast is exceptionally included.

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