• Title/Summary/Keyword: Regional Medical Center

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Reconstruction of post-burn anterior neck contractures using a butterfly design free anterolateral thigh perforator flap

  • Lellouch, Alexandre G.;Ng, Zhi Yang;Pozzo, Victor;Suffee, Tabrez;Lantieri, Laurent A.
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.194-197
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    • 2020
  • Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years' followup after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.

Natural Iminosugar Derivatives of 1-Deoxynojirimycin Inhibit Glycosylation of Hepatitis Viral Envelope Proteins

  • Jacob, James R.;Mansfield, Keith;You, Jung-Eun;Tennant, Bud C.;Kim, Young-Ho
    • Journal of Microbiology
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    • v.45 no.5
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    • pp.431-440
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    • 2007
  • A silkworm (Bombyx mori L.) extract known to contain naturally occurring iminosugars, including 1-deoxynojirimycin (1-DNJ) derived from the mulberry tree (Morus alba L.), was evaluated in surrogate HCV and HBV in vitro assays. Antiviral activity of the silkworm extract and one of its purified constituents, 1-DNJ, was demonstrated against bovine viral diarrhea virus (BVDV) and GB virus-B (GBV-B), both members of the Flaviviridae family, and against woodchuck hepatitis virus (WHV) and hepatitis B virus (HBV), both members of the Hepadnaviridae family of viruses. The silkworm extract exhibited a 1,300 fold greater antiviral effect against BVDV in comparison to purified 1-DNJ. Glycoprotein processing of BVDV envelope proteins was disrupted upon treatment with the naturally derived components. The glycosylation of the WHV envelope proteins was affected largely by treatment with the silkworm extract than with purified 1-DNJ as well. The mechanism of action for this therapy may lie in the generation of defective particles that are unable to initiate the next cycle of infection as demonstrated by inhibition of GBV-B in vitro. We postulate that the five constituent iminosugars present in the silkworm extract contribute, in a synergistic manner, toward the antiviral effects observed for the inhibition of intact maturation of hepatitis viral particles and may complement conventional therapies. These results indicate that pre-clinical testing of the natural silkworm extract with regards to the efficacy of treatment against viral hepatitis infections can be evaluated in the respective animal models, in preparation for clinical trials in humans.

Clinical Impact of Supplementation of Vitamins B1 and C on Patients with Sepsis-Related Acute Respiratory Distress Syndrome

  • Yoo, Jung-Wan;Kim, Rock Bum;Ju, Sunmi;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.248-254
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    • 2020
  • Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

Application of Liquid Amino-fertilizer for Greenup Promotion during Spring Season (Greenup 촉진을 위한 액상아미노산비료의 사용)

  • Chang, Tae-Hyun;Gang, Jae-Young;Park, Se-Young;Chang, Seog-Won;Lee, Yong-Se
    • Asian Journal of Turfgrass Science
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    • v.24 no.1
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    • pp.36-44
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    • 2010
  • We were investigated turf color and Normalized Difference Vegetation Index (NDVI) to affect greenup promotion of 38 cultivar in 5 species for spring season, most popularly used in Korea golf courses. Kentucky bluegrass (Poa pratensis L.), tall fescue (Festuca arundinacea Schreb), creeping bentrgass (Agrostis palustris Huds), perennial ryegrass (Lolium parenne L.) and zoysiagrass (Zoysia spp.) cultivar had higher leaf color for greenup promotion in Ami, Amx and Oligo than Con treatment and there were also significantly difference among treatments. Turfgrass NDVI also showed significant difference among cultivars in species. Spray of Ami, Amx and Oligo has the higher value of turf NDVI than Con. Based on our results, green up fast during spring season may affected much more with application of Ami, Amx and Oligo than Con.

Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer's Disease

  • Im, Jooyeon J.;Jeong, Hyeonseok S.;Park, Jong-Sik;Na, Seung-Hee;Chung, Yong-An;Yang, YoungSoon;Song, In-Uk
    • Dementia and Neurocognitive Disorders
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    • v.16 no.3
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    • pp.72-77
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    • 2017
  • Background and Purpose Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). Methods A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups. Results The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group. Conclusions The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.

Analysis of Characteristics of Thoracic Injury Patients and Nursing Interventions Using Nursing Intervention Classification by Emergency Room Type (응급실 유형에 따른 흉부외상환자의 특성과 간호중재분류체계를 활용한 간호중재 분석)

  • Kim, Kiung;Kim, Yunhee
    • Journal of Korean Biological Nursing Science
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    • v.23 no.4
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    • pp.257-266
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    • 2021
  • Purpose: The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). Methods: Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients' data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. Results: There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. Conclusion: This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.

A Study on the Spatiotemporal Characteristics of Chemical Discharges and Quantified Hazard-Based Result Scores Using Pollutant Release and Transfer Register Data (화학물질배출이동량 자료를 활용한 화학물질배출량 및 유해기반지수 정량화와 시공간 특성 연구)

  • Lim, Yu-Ra;Gan, Sun-Yeong;Bae, Hyun-Joo
    • Journal of Environmental Health Sciences
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    • v.48 no.5
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    • pp.272-281
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    • 2022
  • Background: The constant consumption of chemical products owing to expanding industrialization has led to an increase in public interest in chemical substances. As the production and disposal processes for these chemical products cause environmental problems, regional information on the hazard level of chemical substances is required considering their effects on humans and in order to ensure environmental safety. Objectives: This study aimed to identify hazard contribution and spatiotemporal characteristics by region and chemical by calculating a hazard-based result score using pollutant release and transfer register (PRTR) data. Methods: This study calculated the chemical discharge and hazard-based result score from the Risk-Screening Environmental Indicators (RSEI) model, analyzed their spatiotemporal patterns, and identified hotspot areas where chemical discharges and high hazard-based scores were concentrated. The amount of chemical discharge and hazard-based risk scores for 250 cities and counties across South Korea were calculated using PRTR data from 2011 to 2018. Results: The chemical discharge (high densities in Incheon, Daegu, and Busan) and hazard-based result scores (high densities in Incheon, Chungcheongnam-do, and some areas of Gyeongsangnam-do Province) showed varying spatial patterns. The chemical discharge (A, B) and hazard-based result score (C, D) hotspots were identified. Additionally, identification of the hazard-based result scores revealed differences in the type of chemicals contributing to the discharge. Ethylbenzene accounted for ≥80% of the discharged chemicals in the discharge hotspots, while chromium accounted for >90% of the discharged chemicals in the hazard-based result score hotspots. Conclusions: The RSEI hazard-based result score is a quantitative indicator that considers the degree of impact on human health as a toxicity-weighted value. It can be used for the management of industries discharging chemical substances as well as local environmental health management.

Gene Expression Profiling of the Habenula in Rats Exposed to Chronic Restraint Stress

  • Yoo, Hyeijung;Kim, Hyun Jung;Yang, Soo Hyun;Son, Gi Hoon;Gim, Jeong-An;Lee, Hyun Woo;Kim, Hyun
    • Molecules and Cells
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    • v.45 no.5
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    • pp.306-316
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    • 2022
  • Chronic stress contributes to the risk of developing depression; the habenula, a nucleus in epithalamus, is associated with many neuropsychiatric disorders. Using genome-wide gene expression analysis, we analyzed the transcriptome of the habenula in rats exposed to chronic restraint stress for 14 days. We identified 379 differentially expressed genes (DEGs) that were affected by chronic stress. These genes were enriched in neuroactive ligand-receptor interaction, the cAMP (cyclic adenosine monophosphate) signaling pathway, circadian entrainment, and synaptic signaling from the Kyoto Encyclopedia of Genes and Genomes pathway analysis and responded to corticosteroids, positive regulation of lipid transport, anterograde trans-synaptic signaling, and chemical synapse transmission from the Gene Ontology analysis. Based on protein-protein interaction network analysis of the DEGs, we identified neuroactive ligand-receptor interactions, circadian entrainment, and cholinergic synapse-related subclusters. Additionally, cell type and habenular regional expression of DEGs, evaluated using a recently published single-cell RNA sequencing study (GSE137478), strongly suggest that DEGs related to neuroactive ligand-receptor interaction and trans-synaptic signaling are highly enriched in medial habenular neurons. Taken together, our findings provide a valuable set of molecular targets that may play important roles in mediating the habenular response to stress and the onset of chronic stress-induced depressive behaviors.

Epidemiologic Trends and Aspects of Severe Fever with Thrombocytopenia Syndrome Outbreaks in Korea and Japan, 2013~2017

  • Lee, Won-Chang;Park, Seung-Yong;Choe, Nong-Hoon;Kwon, Young Hwan
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.2
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    • pp.75-79
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    • 2020
  • This study focuses on the comparative and quantitative analysis of the epidemiologic trends and aspects of severe fever with thrombocytopenia syndrome (SFTS) outbreaks between Korea and Japan from 2013 to 2017. The following factors were analyzed; cumulative incidence rate (CIR), cases-fatality rate (CFR), and the epidemic aspects, including cases related to gender, male-to-female morbidity ratio (MFMR), age, seasonal, and geographical distributions. We observed 607 SFTS cases with CIR in Korea during the period 2013 to 2017 were as 0.24 per 100,000 populations and with a 127 fatal-cases (F.C.s), corresponding to a CFR of 20.9%, respectively. During the same period in Japan, 319 SFTS cases with a CIR of 0.05 and with 60 F.C.s to a CFR of 18.8% observed. When compared, the CIR of SFTS in Korea was significantly higher than in Japan (P<0.01), but there were no significant differences levels of the CFR and MFMR between Korea and Japan. Also, a higher incidence of SFTS was observed in people aged over 50-years or elders in Korea and those of 60-years or elders in Japan (P<0.01). The seasonal distribution of SFTS outbreak cases showed that the incidence in summer through autumn in Korea (92.4% of total cases) was higher than in Japan (65.2%), while the outbreaks of SFTS in spring was much higher in Japan (31.0%) than in Korea (7.4%), (P<0.01). The regional distribution revealed no significant difference between the eastern area (44.8%) and the western area (46.8%) of the Korean peninsula except Jeju-island (8.4%). However, in Japan, the incidence only occurred in Chubu-Kinki-Chugoku (30.3%), Shikoku (25.7%), Kyushu (42.6%) and Okinawa (0.3%), which are the western and southern areas of Japan. These differences in SFTS occurrence may reflect the influences of vector/hosts, climate, and geographical and cultural characteristics between the two countries.

Impact of Highway Construction on the Regional Economy: Gangil-Chuncheon Highway (고속도로 건설이 지역경제에 미치는 기여도 분석연구: 강일~춘천 고속도로)

  • Na, Sung-Yong;Lee, Du-Heon;Kim, Hyun-Woo
    • Journal of the Korean Society of Industry Convergence
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    • v.25 no.6_3
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    • pp.1183-1190
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    • 2022
  • Recently, the Ministry of Strategy and Finance announced a plan to reduce the proportion of economic evaluation in non-metropolitan areas and strengthen balanced development evaluation through the reorganization of the preliminary feasibility study system. In addition, the social value of the quality of life, such as job, environment, and safety, which may be affected by the implementation of transportation facility investment projects, was reflected as the main item of policy evaluation. In this study, the ripple effect of the project in terms of social value was reviewed for the Gangil-Chuncheon. The effect of highway opening was investigated by reviewing the feasibility report, post-evaluation report, and statistical indicators. Recently, the Gangil-Chuncheon highway is getting used by around 110,000 people per day. The number of tourists in Chuncheon rapidly has increased from 5 million a year to more than 11 million now. In addition, it was confirmed to produce effects such as population migration, net inflow and land price increase, improvement of living convenience, and expansion of emergency medical care. Although this ripple effect was influenced by various socio-economic factors as well as the opening of the highway, it is clear that it is difficult to occur without the opening of the highway. It is judged that the evaluation of indirect benefits and social values due to the opening of the highway can be quantified through continuous research and data construction. Post-evaluation of construction works, including project efficiency evaluation and ripple effect evaluation, is performed for construction works with a construction cost of more than 50 billion won. In the future, we will continuously improve the evaluation system in order to evaluate the indirect benefits and social values of public investment projects.