• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.19-27
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• 2008

Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.

• Health Policy and Management
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• v.25 no.3
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• pp.149-151
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• 2015

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.435-444
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• 2023

Background: Edwards Intuity is recognized as a relatively contraindicated bioprosthesis for bicuspid aortic valve disease. This study compared the early echocardiographic and clinical outcomes of rapid-deployment aortic valve replacement for bicuspid versus tricuspid aortic valves. Methods: Of 278 patients who underwent rapid-deployment aortic valve replacement using Intuity at Seoul National University Hospital, 252 patients were enrolled after excluding those with pure aortic regurgitation, prosthetic valve failure, endocarditis, and quadricuspid valves. The bicuspid and tricuspid groups included 147 and 105 patients, respectively. Early outcomes and the incidence of paravalvular leak were compared between the groups. A subgroup analysis compared the outcomes for type 0 versus type 1 or 2 bicuspid valves. Results: The bicuspid group had more male and younger patients. Comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease, were less prevalent in the bicuspid group. Early echocardiographic evaluations demonstrated that the incidence of ≥mild paravalvular leak did not differ significantly between the groups (5.5% vs. 1.0% in the bicuspid vs. tricuspid groups, p=0.09), and the early clinical outcomes were also comparable between the groups. In the subgroup analysis between type 0 and type 1 or 2 bicuspid valves, the incidence of mild or greater paravalvular leak (2.4% vs. 6.7% in type 0 vs. type 1 or 2, p=0.34) and clinical outcomes were comparable. Conclusion: Rapid-deployment aortic valve replacement for bicuspid aortic valves demonstrated comparable early echocardiographic and clinical outcomes to those for tricuspid aortic valves, and the outcomes were also satisfactory for type 0 bicuspid aortic valves.

• Clinics in Shoulder and Elbow
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• v.27 no.2
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• pp.203-211
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• 2024

Background: Little is known about alterations of the rotator cuff (RC) macroscopic vasculature associated with medical conditions and/or habits that predispose a person to diseases of the peripheral microcirculation. The high frequency of cuff tear and re-tear in patients with diabetes, hypercholesterolemia, uncontrolled arterial hypertension, or metabolic syndrome may be due to tissue hypovascularity. Methods: The macroscopic vasculature of both the articular and bursal sides of the posterosuperior RC was evaluated arthroscopically in 107 patients (mean age, 58.2 years) with no RC tear. Patients were divided into three groups according to medical comorbidities and lifestyle factors (group I, none; group II, smokers and/or drinkers and one comorbidity; and group III, two or more comorbidities). Pulsating vessels originating from both the myotendinous and osteotendinous junctions were assessed as "clearly evident," "poorly evident," or "not evident." Results: Groups I, II, and III comprised 36, 45, and 26 patients, respectively. Within the myotendinous junction, vessels were visualized in 22 group I patients (61%), 25 group II patients (55%), and 6 group III patients (23%) (P=0.007). Pulsating arterial vessels originating from the osteotendinous junction were seen in 42%, 36%, and 0% of patients, respectively (P<0.001). Within the bursal side of the RC, a dense anastomotic network was visualized (either clearly or poorly) in 94% (34), 80% (36), and 35% (9) of patients, respectively (P<0.001). Conclusions: The macroscopic vasculature of the RC is influenced by pre-existing diseases and lifestyle factors, which may impair peripheral microcirculation.

• The Korean Journal of Food And Nutrition
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• v.22 no.2
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• pp.215-222
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• 2009

The principal objective of this study was to assess the demands and satisfactions of silver welfare professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate elderly individuals and employees related with them in terms of their recognition, interest, and involvement in a labor training program. The sources of health information the subjects received included mass media(50%) and health professionals(41%), and they tended to trust the information they received from health professionals(64%) and the mass media(26%). In the case of health professionals working at silver care facilities, the sources of health information to which they had access were: mass media (51%), health professionals(20%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health(18%). Elderly subjects' reasons for satisfaction with the facilities were as follows: access to meals(32%), elderly communities(24%), and good facilities(22%), whereas the reason subjects reported dissatisfaction with social difficulties(68%), bad facilities(20%), and programs(12%). The degrees of satisfaction of the respondents with the facility's employees were reported as follows: life manager(28%), nurse(16%), and social worker(15%), whereas the subjects reported some degree of dissatisfaction with: nurses(29%), care helpers(17%), and facilities officers(13%). The priorities of the elderly welfare-related information were: disease and health(49%), daily life support(17%), nursing(11%), welfare facilities(8%), and the principal issues they reported as being relevant to elderly individuals were: palsy(16%), arthritis(14%), diabetes (12%), hypertension(10%), dementia(6%). They reported that the most important personnel for elderly in the future would be care managers(44%) and care helpers(21%). Via this developmental program of silver health care professionals, a variety of new job opportunities may be provided in the future, and a program related to the silver service industry must be established as soon as possible.

• Korean Journal of Health Education and Promotion
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• v.18 no.3
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• pp.89-102
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• 2001

Background: Many chronic diseases are associated with the lifestyle such as smoking, alcohol drinking and exercise. Attention is increasingly paid on the effect of exercise for the management of chronic disease these days. Objective: The purpose of this study was to evaluate the status of the smoking habit, alcohol drinking and physical exercise of the patients with chronic diseases. Methods: Total 793 persons(normal:422, chronic disease patients:371) in a hospital were questioned regarding the habits of smoking and alcohol drinking, and a practice of physical exercise in 1999. The patients with chronic illness were divided into three groups(Group I included the patients of hypertension and diabetes mellitus. Group II includes respiratory disease and cancer. Group III included liver disease). The rate of exercise, the rate of smoking cessation and the rate of abstinence were assessed. In logistic regression analysis with each independent variables in each disease groups (I, II and III, odds ratio for the presence of disease was controlled for age and education. Results: The rate of exercise, the rate of smoking cessation and the rate of abstinence was 31.5%, 27.3% and 9.5% in the patients with chronic disease, respectively. In control group, those were 31.5%, 21% and 2.1%, respectively. In logistic regression analysis with exercise as independent variable, odds ratios(95% CI for age and education were significantly high, with smoking cessation, odds ratio for age was high and with abstinence, odds ratio for disease with high in all disease groups. Conclusion: It was suggested that an effort for proper changes of lifestyle related to disease such as smoking, alcohol drinking and exercise should be intervened in the patients with chronic diseases.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.260-271
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• 2002

Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.26 no.1
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• pp.63-74
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• 2013

Objective : Low level laser therapy(LLLT) is conjugated many different diseases such as skin disease, nervous system disease, cardiovascular disease, etc. This study was tried to survey the conjugation of LLLT in field of ophthalmology, otolaryngology and dermatology of Korean Medicine. Methods : In this study, LLLT deal with the field of ophthalmology, otolaryngology and dermatology was searched at Pubmed and NDSL. We searched Pubmed and NDSL with the title "Laser Therapy and Low-Level" for the last 10 years and analyzed disease, laser type, sample size, effect, journal and year. Results : Using Pubmed and NDSL, 8 treatises were researched. About 8 treatises, 7 treatises were papers in field of dermatology, 1 treatise was ophthalmology. And about 8 treatises, 6 treatises were foreign papers and 2 treatises were domestic papers on clinical application of laser status. Mainly used type of laser was a He-Ne laser and Diode laser. The diseases were ocular hypertension, acne, ulcers in patients with leprosy sequelae, freckles, segmental-type vitiligo lesions, diabetes-linked skin lesion, facial skin melanin and elasticity, atopic dermatitis symptom. As a result, we found that treat group had more improvement than control group in 7 of the 8 treatises, that treat group had no difference control group on effect significantly only 1 treatise. Conclusions: As therapeutic tool, LLLT's application range is very wide in the field of ophthalmology, otorhinolaryngology, and dermatology. Keep up with the increasing interest of domestic and foreign about laser therapy, clinical tries on the use of laser will be studied steadily. It is necessary to have sustained attention and research on the point of view of the Korean Medicine.

• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.97-113
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• 1998

BACKGROUND The purpose of this study was to investigate disability of the patients after stroke, clinical applicability and usefulness of the FIM in evaluating the functional abilities and to assess the characteristics of the patients after stroke. And this study examined difference by predictive factors on the treatment outcome. METHOD The study was composed of 31 stroke patients who were within 1 week after stroke and had been treated in hospital more than 4 weeks. Improving rate was measured by using the Functional Independence Measure(FIM), and the correlation was analyzed between Motor FIM and Cognitive FIM. We analyzed significant meaning statistically in the mean value of FIM. RESULT 1. There was no significant meaning statistically in the mean value of FIM that was between both at admission and after 2 weeks. But there was proportional correlation between both at admission and after 4 weeks, and significant meaning statistically. 2. There was proportional correlation between both FIM and Motor FIM, and significant meaning statistically. But there was no significant meaning statistically between both FIM and Cognitive FIM. 3. There was no significant meaning statistically between both FIM and sex, age, side of weakness, stroke subtype, hypertension, hypercholesterolemia, diabetes mellitus, heart disease, starting point of rehabilitation therapy and past history of cerebral vascular accident. While dysarthria affected functional recovery in stroke patients, and significant meaning statistically. CONCLUSION 1. FIM appeared to be a valid and reliable method to measure the functional abilities of the patients after stroke. 2. Only one thing between Motor FIM and score didn't influence FIM score. 3. Dysarthria affected functional recovery in stroke patients, and it is the statistically significant factor.

• Journal of Forest and Environmental Science
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• v.29 no.4
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• pp.257-274
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• 2013

Ecological and ethnomedicinal survey of plants was conducted in one hundred and twenty homesteads in Mbala, Amuda, Umuaku, and Nneato communities of Nneochi Local Governement Area, Abia State-Nigeria. A total of ninety-one medicinal plant species belonging to seventy-eight genera and forty-eight families, used in the treatment of malaria, yellow fever, fibroid, hepatitis, convulsion, hypertension, diabetes, insomnia, ulcer, rashes, low sperm count, snake bite, among others, were documented. Plant remedies were prepared mostly as infusions or decoctions from different plant parts with mainly water, and palm wine/gin sometimes. The highest number of medicinal plant species (73) was recorded in Mbala, followed by Amuda (71), Umuaku (68) and Nneato (61). Medicinal plant species diversity was highest in Amuda (Simpson 1-D=0.9621;H=3.663), followed by Umuaku (Simpson 1-D=0.9481; H=3.471), Mbala (Simpson 1-D=0.9345; H=3.341), and Nneato (Simpson 1-D=0.9307; H=3.277), respectively. Similarity in medicinal plant species was highest between Umuaku and Nneato (76.71%), followed by Amuda and Umuaku (75.95%), Mbala and Amuda (71.43%), while Mbala and Nneato had the lowest similarity (59.52%). The results of the study showed that traditional medicine is pivotal in the treatment of ailments in the study area, and that the indigenous people of Nneochi have recognized the need to conserve medicinal plants of importance ex situ within homesteads due to threats from unsustainable exploitation and deforestation.