• Journal of Nutrition and Health
• /
• v.37 no.8
• /
• pp.675-687
• /
• 2004

This study is designed to assess the prevalence at risk of malnutrition according to the Mini Nutritional Assessment (MNA) and evaluate the factors influencing on the nutritional risk of the elderly. Three hundred and nine elderly (110 men and 199 women: mean age =74.1) who participated in meal service in the Chung-buk province were investigated. Mean MNA total score was 21.9 and women had significantly lower MNA scores than men (respectively, 21.5 and 22.8). In the mean time mean MNA-SF (Short Form) score was 10.7, respectively 10.6 for the women and 11.0 for the men, with the difference being statistically significant. The MNA classified 33% of the elderly as well-nourished, 61.7% as at risk of malnutrition and 5.3% as overt malnourished. However, MNA-SF categorized the examinees 40.2% as good and 59.8% at nutritional risk. Those who identified as malnourished elderly had significantly lower mean BMI, mid-arm and calf circumference, poorer functional abilities (ADL, IADL) , lower MAR and food habits scores, and higher number of nutrient $\leq$ 75% of RDA than those with at risk of malnutrition and well nourished. Also socioeconomic status such as educational level, self-rated economic status, poverty level, and marital status significantly influenced nutritional status. Similar effect was observed in self-rated nutritional status and health status, dental status, appetite change according to MNA score. Stepwise multiple regression analysis indicated that weight loss was the most predictive item in the total MNA and MNA-SF score. It was found that items such as mobility, living status (home vs institution) , mode of feeding, and pressure sores were inappropriate for assessment of the elderly who are able to participate meal service program. Also, some modifications of items in MNA are needed in order to apply to Korean elderly. Even though the MNA seems to be an useful tool to screen those old people at risk of malnourished, a lot of work is still to be done with this assessment tool to secure its reliability.

• Archives of Plastic Surgery
• /
• v.40 no.1
• /
• pp.44-50
• /
• 2013

Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

• Archives of Reconstructive Microsurgery
• /
• v.25 no.2
• /
• pp.49-55
• /
• 2016

Purpose: Soft tissue defects in the lumbosacral area can be challenging to treat, and various methods to accomplish this have been proposed, including the use of perforator flaps. Herein, we present our experience with superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flaps for the reconstruction of lumbosacral defects. Materials and Methods: From March 2013 to July 2016, 28 cases (27 patients) of lumbosacral defects were treated by reconstruction with SGAP or IGAP flaps. The defects were caused by pressure sores (21 cases), burns (3 cases), tumor resection (2 cases), scars (1 case), or foreign body infection (1 case). Reliable perforators around the defect were found using Doppler ultrasound. The perforator flaps were elevated with a pulsatile perforator and rotated to cover the defects. Results: Twenty-three SGAP and 5 IGAP flap reconstructions were performed. The mean flap size was $9.2{\times}6.1cm^2$ (range, $5{\times}3cm^2$ to $16{\times}10cm^2$). Donor sites were closed by primary closure. Partial flap necrosis occurred in two cases, and minor complications of wound dehiscence occurred in 3 cases, which were healed by primary closure. The mean follow-up period was 4.4 months (range, 1~24 months). Conclusion: Gluteal-based perforator flaps can be safely harvested due to pliability and reliable vascularity in the gluteal area, reducing donor site morbidity without sacrificing the underlying muscles. Thus, these flaps are useful options for the reconstruction of lumbosacral defects.

• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.415-420
• /
• 2011

Purpose: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. Methods: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. Results: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. Conclusion: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.

• Journal of Home Health Care Nursing
• /
• v.31 no.1
• /
• pp.44-55
• /
• 2024

Purpose: This is a retrospective secondary data analysis study based on real-world data to analyze the level of nursing care needs of patients in a comprehensive nursing care service ward, and identify factors influencing nursing needs. Methods: Study participants included patients admitted to two comprehensive nursing care service wards at a tertiary general hospital located in Gyeonggi-do, Korea. After obtaining permission from the health and medical information team of the target hospital, data were collected from their electronic medical records. Nursing care needs were measured using seven items on nursing activity and four items on daily living activities developed by the National Health Insurance Service (NHIS). The collected data were analyzed using the SPSS version 29.0 with frequency and percentage, mean and standard deviation, minimum and maximum values, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression. Results: The level of nursing care needs of patients in comprehensive nursing care service wards was found to be higher for patients with pressure sores (β=.33), older patients (β=.26), patients who underwent procedures (β=.15), patients with present guardians (β=.15), and patients with more comorbidities (β=.10). The total explanatory power was 51.0%. Conclusion: It is necessary to accurately identify patients' nursing care needs and provide nursing care according to priority by considering the characteristics of patients in comprehensive nursing care service wards.

• Journal of Life Science
• /
• v.25 no.5
• /
• pp.523-532
• /
• 2015

A variety of previous pharmacological studies have suggested Liriope platyphylla (L. platyphylla) may exert beneficial biological effects on inflammation, diabetes, neurodegenerative disorder, obesity, constipation, and atopic dermatitis. In addition, hydrocolloid membranes (HCMs) have attracted attention in dermatological care, including in the treatment of scleroderma skin ulcers, cutaneous ulcers, permanent tympanic membrane perforations, pressure sores, and decubitus ulcers in the elderly. To investigate the therapeutic effects of HCM containing an aqueous extract of L. platyphylla (HCM-LP) on second-degree burn wounds, their physico-chemical properties were analyzed and the therapeutic effects were observed in SD rats after treatment with HCM-LP for 14 days. Significant declines in tensile strength (38.4%) and absorptiveness (46.3%), as well as an increase in surface roughness (38.1%) were detected in HCM-LP compared with that of HCM. In SD rats with burned skin, the wound diameter was shorter in the HCM-LP treated group than in the GZ group on post-surgical day 14, while the significant improvements in scar tissue reduction, epithelium regeneration, angiogenesis, and extracellular matrix deposition were observed in the HCM-LP-treated group during all experimental periods. Overall, these results suggest HCM-LP may accelerate the process of healing the burn injury skin of SD rats through the regulation of angiogenesis and connective tissue formation.

• The Journal of Internal Korean Medicine
• /
• v.41 no.6
• /
• pp.1191-1199
• /
• 2020

We studied the effect of Korean medicine treatment on the clearance of vancomycin-resistant enterococcus (VRE) colonization and on improvement in symptoms in a stroke patient. The patient was continuously followed up with stool VRE cultures while being treated with herbal medicine, Chunglijagam-tang, acupuncture, and oxygen therapy. We also checked the coccygeal pressure sore condition and the oxygen levels during therapy. No VRE colonization was found after treatment and the oxygen levels and pressure sores had improved. This study proved that Korean medicine treatment could be effective for the clearance of VRE colonization and improvement of symptoms.

• Korean Journal of Clinical Laboratory Science
• /
• v.51 no.2
• /
• pp.260-264
• /
• 2019

An 84-year-old woman presented to the emergency department with a chief complaint of pressure sores of the anus. She had a urine catheter when she showed pyuria three times but had no fever. A microscopic examination revealed many grapevine-like Gram positive strains and neutrophils. After 24 hours of urine culture on blood agar, non-hemolytic mucous colonies were found and further enlarged after 48 hours of culture. The capsules were identified after India ink stain. The catalase was positive, but the tube coagulase and latex coagulase were both negative. The S. aureus was identified by Vitek-2 and mass spectrometer Vitek MS V-3 IVD. The strain was confirmed by 16S rRNA gene sequencing and multilocus sequence typing (MLST). The phenotypically atypical MRSA found in the tube coagulase and latex coagulase were both negative. MRSA often show no beta hemolysis as in this case but are rarely latex coagulase-negative. We report a woman whose urine culture showed non-hemolytic, tube coagulase-negative, and latex coagulase-negative MRSA.