• Archives of Plastic Surgery
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• v.51 no.1
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• pp.94-101
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• 2024

Background For the small glabrous skin defect, Thenar and Hypothenar skin are useful donors and they have been used as a free flap. Because of similar skin characteristics, both flaps have same indications. We will conduct comparative study for the donor morbidity of the Free thenar flap and Hypothenar free flap. Methods From January 2011 to December 2021, demographic data, characteristics of each flap, and complications using retrospective chart review were obtained. Donor outcomes of the patient, who had been followed up for more than 6 months, were measured using photographic analysis and physical examination. General pain was assessed by Numeric Rating Scale (NRS) score, neuropathic pain was assessed by Douleur Neuropathique 4 Questions (DN4) score, scar appearance was assessed by modified Vancouver Scar Scale (mVSS), and patient satisfaction was assessed on a 3-point scale. Statistical analysis was performed on the outcomes. Results Out of the 39 survey respondents, 17 patients received Free thenar flaps, and 22 patients received Hypothenar free flaps. Thenar group had higher NRS, DN4, and mVSS (p < 0.05). The average scores for the Thenar and Hypothenar groups were 1.35 and 0.27 for NRS, 2.41 and 0.55 for DN4, and 3.12 and 1.59 for mVSS, respectively. Despite the Hypothenar group showing greater satisfaction on the 3-point scale (1.82) compared with the Thenar group (1.47), the difference was not significant (p = 0.085). Linear regression analysis indicated that flap width did not have a notable impact on the outcome measures, and multiple linear regression analysis revealed no significant interaction between flap width and each of the outcome measures. Conclusion Despite the limited number of participants, higher donor morbidity in general pain, neuropathic pain, and scar formation was noted in the Thenar free flap compared with the Hypothenar free flap. However, no difference in overall patient satisfaction was found between the two groups.

• Therapeutic Science for Rehabilitation
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• v.7 no.4
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• pp.19-30
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• 2018

Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.87-92
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• 2014

Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.51-57
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• 2018

Objectives Low back disability, along with low back pain, places a significant social burden in terms of work loss and medical expenses. Motion-Style-Acupuncture-Treatment using Traction (T-MSAT) is employed as one of the conservative treatments to such conditions. In the present study, effectiveness of Korean Medical treatments, including T-MSAT, was investigated in inpatients with low back disability and low back pain. Methods Among the patients who were admitted between January 2018 to June 2018 with disabled low back function, ones that were treated with T-MSAT were identified. Pain and function were compared at the point of admission and discharge, using Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI), respectively. Results Over the hospitalization period of 34.55 days, pain intensity significantly decreased from NRS score of 6.14 to 3.26 and low back function also significantly improved from ODI score of 50.93 to 33.73 upon receiving Korean Medical treatments including T-MSAT. Conclusions Korean Medical treatments including T-MSAT were found to be effective in inpatients with low back disability with a statistical significance. To evaluate the sole effectiveness of T-MSAT, rigorous clinical trials are necessitated in future.

• The Journal of Korean Obstetrics and Gynecology
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• v.33 no.1
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• pp.86-103
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• 2020

Objectives: The purpose of this study is to analyse the domestic trends of Traditional Korean Medicine on Hot flush in menopausal women. Methods: We searched six databases and selected relevant papers according to the criteria. Results: 12 papers included case report, literature review, randomized controlled clinical trials (RCTs), Non-RCTs, and retrospective chart analysis study design. 1. The daily diary, Kupperman's Index, Menopause Rating Scale, Menopause-specific Quality of Life Questionnaire, Digital Infrared Thermographic Imaging were used as a measure of the symptoms of hot flush. 2. There were significant correlations between Thermographic images, Pulse energy, Lifestyle Habits, Low frequency power/High frequency power (LF/HF) ratio and certain items of Menopausal Symptoms Measurement. 3. The case report using Er-Xian decoction and Hwangryunhaedoktang-Gamibang showed significant effect. 4. Domestic RCT studies using herbal or acupuncture treatments showed a significant value of 3.4 on average in the quality assessment conducted in the study. However, the number of domestic studies included was five, which is not enough compared to foreign countries. Conclusions: This study examined domestic research trends on hot flushes of menopausal women and found that various evaluation tools and diagnostic methods were applied. It is necessary to conduct various RCT studies in Korea, where the number of studies is insufficient compared to overseas.