• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.886-891
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• 2010

Purpose: This study aims to investigate the clinical characteristics of children diagnosed with the novel influenza A (H1N1) in the winter of 2009 at a single medical institution. Methods: Out of 545 confirmed cases of influenza A (H1N1) in children, using the real time RT-PCR method at Kosin University Gospel Hospital from September to December of 2009, 149 patients and their medical records were reviewed in terms of symptoms, laboratory findings, complications and transmission within a family. Results: Median age of subjects was 7 years (range: 2 months-18 years). New cases increased rapidly from September to reach a peak in November, then declined rapidly. Most frequently observed symptoms were fever (96.7%), cough (73.2%), rhinorrhea (36.9%) and sore throat (31.5%). Average body temperatures on the 1st, 2nd and 3rd hospital day were $38.75{\pm}0.65^{\circ}C$, $38.08{\pm}0.87^{\circ}C$ and $37.51{\pm}0.76^{\circ}C$, respectively. Complete blood counts and biochemical tests performed on the first admission day showed within the reference values in most cases. Of the 82 patients with simple chest radiography, 18 (22%) had pneumonic lesions; multi-focal bronchopneumonia in eleven, single or multi-segmental lobar pneumonia in five, and diffuse interstitial pneumonia in two patients. All of the 149 patients improved from their symptoms and discharged within 9 days of admission without any late complication. Conclusion: Children with 2009 pandemic influenza A (H1N1) at our single institution displayed nonspecific symptoms and laboratory findings, resembling those of common viral respiratory illnesses, and did not appear to develop more severe disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권4호
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• pp.405-411
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• 1991

To determine the sterility of the prepared allogeneic bone of the human, culture of the allografts prior to implantation was performed on fresh-frozen and freeze-dried bone. Before the use of allografts to the patients, it must be confirmed about the sterility, cellular cytotoxicity, immune reaction, and osteoinductive potential as a biomaterials. Oral and maxillofacial surgeons demand for allograft bone will be increased in the future. Wonkwang Bone Bank attempted to meet this demand, has performed series of experimental study on the allograft bone of the Koreans to evaluate the physical and chemical suitability of the bone since the surgeons applications will have broadened from benign cystic lesions to fracture malunions and non-unions, large segmental defects, and whole-bone allorgrafts after tumor surgery. The results obtained were as follows: 1. Freeze-drying(FD) only shoed some bactericidal effects of the normal and osteo bone but in cases of performing EO gas sterilization, the FD effects was not clear. 2. The fact that FD has little effect than the EO gas sterilization on normal bone postulated that the presence of microbiota may be due to an operation and bone processing procedure. 3. FD and EO gas sterilization had a remarkable effect on the osteo bone. 4. The sterilization effect were EO gas, Freeze-drying, Fresh-Frozen with descending order. But all sterilization method were not complete to preserve and implant allograft bone. We are now performing further continuous study on the radiation and chemical sterilization procedure to make safe and complete allograft bone.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.159-164
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• 2008

Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

• 대한물리의학회지
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• 제2권2호
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• pp.205-212
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• 2007

Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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• pp.97-107
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• 1999

The osteogenic capacity of the vascularized periosteum autograft has been extensively demonstrated by experimental works. The objective of this study was to characterize the behavior of experimental model of vascularized periosteal flap(VPF) by observing sequential stages of osteogenesis after simulated VPF in rabbits. In experimental group, segmental resection of bone including the periosteum was performed in 22 radii of 22 New Zealand white rabbits preserving the periosteal circulation of median artery to the periosteum. In order to simulate the transplantation of VPF, the vascular pedicle consisting of median artery and veins was dissected from adjacent soft tissue and the periosteum was longitudinally incised to remove the bone followed by repair of the periosteum. From the first to sixteenth week after the simulated VPF, the changes in VPFs were observed by radiological, light microscopical, scanning electron microscopical methods and the activity of osteocalcin was measured by immunohistochemical method. In control group, the bone tissue and periosteum were completely removed from the mid-shaft of radius and the findings were observed by radiological and light microscopical methods. From the results of this study, it is demonstrated that the experimental model of VPF is vigorously and uniformly osteogenic. Therefore it is thought that VPF can be used as a measure to treat bone defect of shaft of long bone.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.125-132
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• 2007

Introduction: Ulna is nearly equal to radius in function and bony architecture and strength in forearm. But in lower extremity, fibula is 1/5 of tibia in anatomic and functional point so we can find fibula transposition is commonly used in defect of tibia. We cannot find other article about segmental forearm bone transposition in man. The purpose of this study was to report our clinical and functional result of undergoing segmented transposition of ipsilateral ulna with its own vascular supply in defect of radius in 6 cases. Material and method: From June 1994 to October 2007, 7 segmented bone transpositional grafts in forearm were performed in Kyung Hee Medical Center. The distribution of age was from 20 years old to 73 years old. There was male in 6 cases and female in 1 case. The causes of operation were giant cell tumor in 1 case and traumatic origin in 6 cases; it was nonunion in 2 cases and fracture with severe comminution in 4 cases. Ipsilaterally segmented ulna keeping its own vascular supply was transported to defect of radius in severe traumatic patients and one patient whose tumor in radius had been excised. Transported ulna was fixed to proximal and distal radius remnants by plate and screw. In one case with giant cell tumor, transported ulna was connected to radius across wrist joint as wrist joint fusion. Joint preserving procedures were performed in 6 cases with crushing injury of radius. Results: We could obtain solid bony union in all cases and good functional results. The disadvantage was relative shortening of forearm, but we could overcome this problem. Conclusion: We think that ipsilateral segmented ulna transposition keeping its own vascular supply to radius can be perfomed with one of procedures in cases with wide defect in radius.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.68-74
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• 2008

Segmental defects of the tibia after open fractures, sepsis and a tumor surgery are among the most difficult and challenging clinical problems. Tibia defects in these situations are complicated with infection and are resistant to conventional bone grafting techniques. The aim of this study is to report the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of tibia defects. Ten patients had free flap followed by IVFT in the period 1989~2007. Mean age was 25.3 years. The patients were followed for an average of 3.4 years. All flaps were survived including 1 case with venous thrombosis requiring additional surgery. The average time to union of proximal and distal end was 5.2 months, 8.2 months, each other. All transposed fibula were viable at last follow-up. IVFT offers the advantages of a vascularized graft. In patients with large bone and soft tissue defects combined with infection, free flap followed by IVFT is an useful and reliable method without microvascular anastomosis.

• Advances in pediatric surgery
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• 제11권2호
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• pp.141-149
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• 2005

Ulcerative colitis, an inflammatory bowel disease, is primarily managed medically with a combination of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, indications and outcome of surgical management of 21 patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were reviewed. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management after diagnosis and 8 patients (38 %) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53 %) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure as a result of sclerosing cholangitis. In 8 patients who received surgical management, the indications for operation were, 1 patient sigmoid colon perforation and 7 patients intractability despite medical management. The perforated case had a segmental colon resection and the other 7 patients underwent total colectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. and 1 is still on medical management because of mild persistent hematochezia after surgery. Six other operated patients are doing well without medical therapy. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation are present. Total colectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.

• 대한기관식도과학회지
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• 제10권1호
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• pp.41-45
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• 2004

Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

• 한국구조물진단유지관리공학회 논문집
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• 제11권5호
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• pp.99-106
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• 2007

본 연구에서는 건설비용, 노무비 절감, 공기단축 등의 요구에 대응하기 위해, 일체형 및 분절형 PSC 거더의 구조적인 거동을 평가하는데 연구목적을 두었다. 본 논문에서는 동일한 단면을 갖는 총 3개의 실험체를 제작하였으며, 접합부와 긴장재의 양을 주요변수로 하여 모멘트-처짐 거동을 비교 분석하였다. 첫 번째 거더는 거더를 일체로 제작하여 세 개의 강연선을 배치하였고 두 번째 거더는 5개의 분절된 세그먼트로 제작하여 세 개의 강연선을 이용하여 각각의 세그먼트를 접합하였다. 그리고 세 번째 거더는 두 번째 거더와 같이 분절된 거더로써 추가 강연선을 배치하였다. 수행된 실험의 결과를 분석함으로써 일체형 거더와 분절형 거더의 거동 차이를 알 수 있었으며, 수행된 2차원 비선형유한요소해석은 실험결과와 비교하여 모멘트-처짐 곡선을 비교적 잘 예측하였다.