• 대한간호학회지
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• 제37권5호
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• pp.781-789
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• 2007

Purpose: The study was conducted to investigate the skin hydration level in various body sites and identify the influencing factors in neonates. Methods: An exploratory comparison study was designed to measure the stratum corneum hydration, using a National DM-R2 on the forehead, abdomen, buttocks, and the back of the hands and feet of 198 neonates including 92 premature infants. Results: The results showed 32.7%-36.5% of stratum corneum hydration for all sites. Premature infants revealed a higher hydration level on the peripheral sites (dorsal hand and feet) than those of the full-term infants, possibly resulting from therapeutic regimens including an incubator or radiant warmer. Infants in an incubator showed a higher hydration level than those in radiant warmers, suggesting more attention to fluid management for infants in the open environment. In addition, all stratum corneum hydration measurements except one, from the forehead, showed a positive correlation with postnatal age in full-term infants while showing no relation to any measurements in premature infants. Conclusion: The study demonstrated the very low skin hydration levels in hospitalized neonates, particularly in premature neonates with more susceptible skin hydration instability despite therapeutic interventions for fluid balance. More vigilant fluid management is imperative in neonates, particularly those in the open environment.

• The Korean Journal of Pain
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• 제7권2호
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• pp.222-230
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• 1994

Acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) on acupuncture site(dorsal and ventral side of finger) were compared with a placebo site(forearm) by infrared thermal imaging. Six disease-free volunteers underwent, on different days, an ALTENS treatment and a placebo treatment in a cross-over sequences of stimulation control and inhibition control in excess of 50 treatments. ALTENS treatments were given at 30Hz at an intensity just below pain threshold delivered to acupuncture points on fingers. Placebo stimulations were administered in similar manner. After every thirty minutes of ALTENS and placebo treatment with stimulation, inhibition control sequence and vice versa, we examined whole body infrared thermal imaging and checked changed skin temperature on frontal, anterior chest, upper and lower abdomen, dorsal and ventral aspect of hand, thoracic and lumbar area, anterior and posterior aspect of lower leg. There were significant skin temperature elevations with ALTENS treatment, especially finger control gate corresponding organ area. Placebo treatment revealed no skin temperature change. We concluded that ALTENS on finger control gate influence physiologic state as opposed to conventional electric stimulation.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.483-488
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• 2012

Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

• 혜화의학회지
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• 제17권2호
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• pp.51-68
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• 2008

The effect of combinational treatment of oral HTGMB and topical CSGMB ("H&C" hereinafter) on the changes of dermal inflammation index and immune system were studied using NC/Nga atopic dermatitis animal model. 1. Through naked eye examination, H&C ameliorated atopic dermatitis compared to the control group. Significant reduction of dermal inflammation index was observed after 12 weeks of treatment. 2. The H&C treated group showed 51% increase in the number of immune cells in DLN, and 59% increase in the number of immune cells is dorsal skin. 3. The H&C treated group showed decrease of 26%, 8%, 59% in CD19+, CD3+/CD69+, B220+/IgE+ cells in DLN respectively. On the other hand, CD3+, CD8+, CD4+ cells were increased by 8%, 31%, 12%, respectively. 4. The H&C treated group showed significant decrease of 38% and 47% in B220+/IgE+, CD11b+/Gr-1+ cells within dorsal skin respectively. Also, a decrease in CCR3+ cells by 21% was observed. 5. Significant decrease of the production of IL-4, IL-5, GM-CSF by 39%, 65%, 60% respectively, in spleen cells activated with CD3 and CD28 were observed in the H&C treated group. The results above strongly suggest significance of anti-atopic dermatitis effect of combinational treatment of oral HTGMB and topical CSGMB through immune modulation. Further applications in clinical use of the treatment are anticipated.

• 대한의용생체공학회:의공학회지
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• 제29권6호
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• pp.493-501
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• 2008

In this paper, a novel system is proposed to measure skin hydration using the susceptance method. This system largely consists of a low-voltage(${\pm}2.6$ V) driven circuit and minimized electrodes of size($5{\times}5mm^2$). To evaluate the accuracy of the novel system in measuring skin hydration, skin hydration values from 105 subjects are measured by the proposed system. The measurements are then compared to those obtained by the golden reference device based on the capacitance method in terms of Intraclass Correlation Coefficient(ICC) and correlation coefficient. All measurements are performed on 7 sites, which are forehead, Crow's foot, cheek, chin, volar forearm, dorsal forearm, and back of the hand, in a room where the temperature and humidity are maintained at an uniform level of $22{\pm}2^{\circ}C$ and $50{\pm}5%$, respectively. ICC values are above 0.9(p=0.001), signifying that the skin hydration values measured by the two methods show a good level of reliability. Correlation coefficient between the two methods is also 0.562(p=0.001). Based on these results, it is expected that the proposed system may be applicable in a variety of clinical or cosmetic areas.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.25-28
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• 2016

Purpose: Reconstruction of small defects of the dorsal fingers and toes is a challenging task. Although adipofascial flap is widely used for these areas, additional refinements are warranted. In this paper, we define the appropriate defect size in the finger and toes that can be treated with the adipofascial flap, refine its surgical indications and present a few surgical tips. Materials and Methods: Twelve patients with dorsal defects of the fingers and toes were treated with a random-type adipofascial turn-over flap and skin graft. If the defect area exceeded the size that could be covered by a conventional design, the flap base was designed in oblique or curvilinear fashion to lengthen the flap. For accurate defect coverage, the width of the flap base was designed in an asymmetrical shape depending on the defect configuration, varying the width from 0.3 to 1.0 cm, as opposed to the standard 0.5 to 1.0 cm width. Moreover, the lateral limit of the flap was defined as the lateral axial line. The size of the defect ranged from $3.0{\times}1.7cm$ to $1.5{\times}1.3cm$. Results: All flaps survived completely. Gliding function of the hand was well preserved and there was no evidence of tendon adhesion. Conclusion: The small defect in the dorsal finger and toe can be defined as less than one phalanx-length, measuring about $3.0{\times}2.0cm$ in size. If the defect exceeds this dimension, it is recommended that a different option be considered. We believe the adipofascial flap is an excellent option for treating small defects.

• Child Health Nursing Research
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• 제24권3호
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• pp.345-352
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• 2018

Purpose: The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters. Methods: SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model. Results: The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was $6.2{\pm}0.3$ on day 1, and decreased to $5.7{\pm}0.2$ (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044). Conclusion: This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.46-51
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• 2010

Purpose: The loss of web space is caused by congenital syndactyly or acquired burn injury, trauma or surgery. Numerous surgical procedures have been described for restoration of the web space. Local flaps are usually preferred because of the easiness to perform and tolerable postoperative outcome. Among the various local flaps, the authors introduce V-M plasty for correction of web space contracture and syndactyly. Method: From March 2007 to Jun 2008, 4 patients underwent V-M plasty for correction of web space contracture and syndactyly. V-M plasty consists of 3 distinct triangular flaps. One triangular flap is designed next to the web region on the dorsal site of the hand, whereas the remaining 2 triangular flaps are placed on the volar site. The dorsal triangular flap is then placed between the volar adjacent triangular flaps. At the end of the operation, the involved fingers or toes are positioned in abduction to avoid kinking of the triangular flaps. Result: All the patients gained web functions with good esthetic appearance without any recurrence or complications. Mean follow-up was 8 months. Conclusion: V-M plasty is a safe, easy and rapid procedure to design and apply by using local tissues without the needs for a skin graft or risk of linear scarring and recurrence. The authors advise this versatile technique both in primary and recurrent cases of web space contracture and syndactyly.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.20-27
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• 1998

Among many kinds of introduced free flaps, scapular freeflap is one of the most popularly using modalities in fasciocutaneous defect coverage with minimal donor defect and easier procedure and constant vascular patterns of the donor. Many surgeons who had experience of this flap pointed out deficit of the reliable sensation of the transplanted flap is the main shortcoming of the scapular free flap. If we can subjugate that point, scapular free flap is the most excellent procedure in such a cases as heel pad reconstruction and hand reconstruction which are relatively important to have skin with protective sensation. Author performed anatomical literature review, 10 cadaveric dissections and 12 clinical dissections. In surgical anatomical aspect, the upper six dorsal rami of the thoracic nerves have medial branches which pierce Longissimus thoracis and Multifidus muscle with small cutaneous twigs which pierce Latissimus dorsi and Trapezius muscle. Among that cutaneous twigs, several twigs distribute to the skin of the back from midline to lateral aspect which territory is identical to scapular free flap. We analysed clinical experiences of that sensory bearing scapular free flap surgical anatomy and one year follow-up studies with several results. 1) Two to three cutaneous twigs which pierced from the Trapezius muscle over the scapular free flap region. 2) Each twigs has two to four nerve fascicles with small artery. 3) The nerve distributed to the ordinary scapular free flap and large enough size and pedicle length to neurorrhapy with various recipient site nerves. 4) The inconvenience of this procedure is the vascular pedicle and nerve pedicle have opposite directions, vascular pedicle of that comes from lateral direction from subscapular vessels, but nerve pedicle comes from medial direction from trapezius muscle. Author can found constant cutaneous nerve branches which come from piercing the Trapezius. This nerves are helpful for protective sensation in transplanted scapular free flap. We can't had enough follow-up and evaluation of the nerve function of this procedure, we need continuous research works to application of this procedure. The in conveniences come from directional differences of pedicle can solve with longer harvest neural pedicle and change direction of the neural pedicle.

• 한국미생물·생명공학회지
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• 제43권2호
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• pp.150-157
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• 2015

본 연구는 BALB/c mice의 등 쪽 부위에 반복적인 DNCB 도포를 통해 유발시킨 아토피 피부염에 있어서 참모자반 물 추출물의 효능에 대해 연구하였다. 참모자반 물 추출물을 2주 동안 지속적으로 처리하고 IL-4 및 IFN-γ cytokine의 분비량, 비장세포 증식능, 혈청 중 총 IgE 함량, 육안 평가 및 skin clinical severity score, 조직관찰을 실시하였다. 그 결과 참모자반 물 추출물을 지속적으로 도포함으로써 IL-4 cytokine과 총 IgE 함량이 현저히 감소하는 것을 확인할 수 있었으며 IFN-γ cytokine은 유의적으로 증가하는 것을 확인하였다. 비장세포 증식능에는 참모자반 물 추출물의 도포처리가 큰 영향을 미치지 않는 것으로 나타났다. 육안평가 및 skin clinical severity score 결과, 참모자반 물 추출물을 2주간 지속적으로 도포 처리하였을 때, 그 증상이 눈에 띄게 완화되는 것을 확인할 수 있었으며 score 또한 DNCB 단독 처리군과 비교 시 유의적으로 감소하였다. 등 조직 관찰에서도 참모자반 물 추출물에 의해 DNCB로 유발된 아토피 동물 실험군의 경피 및 진피 조직 두께 및 진피에서의 mast cell의 침윤 정도가 감소되었음을 확인하였다. 이상 결과를 종합 해볼 때, 참모자반 물 추출물이 아토피 피부염 치료제로서 이용 가능성이 있을 것으로 사료된다.