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Nail bed defect reconstruction using a thenar fascial flap and subsequent nail bed grafting

  • Lee, Kyung Jin;Kim, Yong Woo;Kim, Jin Soo;Roh, Si Young;Lee, Dong Chul
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.57-62
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    • 2019
  • Background Full-thickness nail bed defects with significant exposure of the distal phalanx are typically challenging to reconstruct. We describe a novel method of nail bed defect reconstruction using a thenar fascial flap combined with nail bed grafting. Methods Full-thickness nail bed defects were reconstructed in a 2-stage operation involving the placement of a thenar fascial flap and subsequent nail bed grafting. A proximally-based skin flap was designed on the thenar eminence. The flap was elevated distally to proximally, and the fascial layer covering the thenar muscle was dissected proximally to distally. The skin flap was then closed and the dissected fascial flap was turned over (proximal to distal) and inset onto the defect. The finger was immobilized for 2 weeks, and the flap was dressed with wet and ointment dressings. After 2 weeks, the flap was divided and covered with a split-thickness nail bed graft from the great toe. Subsequent nail growth was evaluated on follow-up. Results Nine patients (9 fingers) treated with the novel procedure were evaluated at follow-up examinations. Complete flap survival was noted in all cases, and all nail bed grafts took successfully. Five outcomes (55.6%) were graded as excellent, three (33.3%) as very good, and one (11.1%) as fair. No donor site morbidities of the thenar area or great toe were observed. Conclusions When used in combination with a nail bed graft, the thenar fascial flap provides an excellent means of nail bed reconstruction.

Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: prospective study of 30 cases

  • Jang, Nam;Shin, Hyun Woo
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.89-93
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    • 2019
  • Background: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. Methods: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. Results: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. Conclusion: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

A Case of Acute Radiation Dermatitis Improved after Korean Medicine Treatment (한방 복합 치료 이후 호전된 급성 방사선 피부염 치험 1례)

  • Baek, Jong-Chan;Choi, Yoon-Young;Byun, Jung-Ah;Hwang, Mi-Lee;Ahn, Jae-Hyun;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.4
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    • pp.181-189
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    • 2022
  • Objectives : The purpose of this study is to report a case of Korean medicine on acute radiation dermatitis. Methods : This study was conducted with an acute radiation dermatitis patient who hospitalized in ophthalmology, otolaryngology & dermatology clinic of Korean medical hospital. The patient was treated with Korean medicine including acupuncture, wet dressing, herbal ointment and phototherapy. We evaluated the patient's subject symptoms before and after treatment using the VAS scale and CTCAE. Results : The patient's subjective symptoms were improved after treatment. Conclusions : It is considered that Korean medicine could be applied to the treatment of acute radiation dermatitis.

Partial Arytenoidectomy in a Horse

  • Seyoung Lee;Eun-bee Lee;Kyung-won Park;Hyohoon Jeong;Jong-pil Seo
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.400-404
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    • 2022
  • A 3-year-old Thoroughbred gelding presented with left laryngeal hemiplegia with a history of laryngoplasty (tie-back surgery) failure. Postoperative endoscopy revealed no abduction or no inflammatory changes in the left arytenoid cartilage. The owner opted for the horse to undergo partial arytenoidectomy due to failed laryngoplasty. A tracheostomy tube was intubated through a mid-cervical tracheotomy to secure the airway under general anesthesia, and; laryngotomy was performed to access the arytenoid cartilage in dorsal recumbency. A partial arytenoidectomy was performed with endoscopic assistance through the left nostril, and the left arytenoid cartilage was removed, excluding the muscular process. Antibiotic and anti-inflammatory agents were administered postoperatively, and the incision site was cleaned using normal saline and antibiotic ointment twice daily. On the 12th postoperative day, endoscopy revealed redundant corniculate process mucosa at the surgical site, which was removed using rongeur forceps directly through the previous laryngotomy incision. The horse showed no significant complications during the hospitalization. Two months after surgery, the surgical site reportedly recovered with no evidence of granulation tissue. The horse returned to training and racing 3 and 7 months postoperatively, respectively. This is the first case report of a partial arytenoidectomy in a horse in South Korea. In this case, the horse returned to training after partial arytenoidectomy without significant complications, indicating that partial arytenoidectomy could be beneficial for failed laryngoplasty.

English Predicate Inversion: Towards Data-driven Learning

  • Kim, Jong-Bok;Kim, Jin-Young
    • Journal of English Language & Literature
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    • v.56 no.6
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    • pp.1047-1065
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    • 2010
  • English inversion constructions are not only hard for non-native speakers to learn but also difficult to teach mainly because of their intriguing grammatical and discourse properties. This paper addresses grammatical issues in learning or teaching the so-called 'predicate inversion (PI)' construction (e.g., Equally important in terms of forest depletion is the continuous logging of the forests). In particular, we chart the grammatical (distributional, syntactic, semantic, pragmatic) properties of the PI construction, and argue for adata-driven teaching for English grammar. To depart from the arm-chaired style of grammar teaching (relying on author-made simple sentences), our teaching method introduces a datadriven teaching. With total 25 university students in a grammar-related class, students together have analyzed the British Component of the International Corpus of English (ICE-GB), containing about one million words distributed across a variety of textual categories. We have identified total 290 PI sentences (206 from spoken and 87 from written texts). The preposed syntactic categories of the PI involve five main types: AdvP, PP, VP(ed/ing), NP, AP, and so, all of which function as the complement of the copula. In terms of discourse, we have observed, supporting Birner and Ward's (1998) observation that these preposed phrases represent more familiar information than the postposed subject. The corpus examples gave us the three possible types: The preposed element is discourse-old whereas the postposed one is discourse-new as in Putting wire mesh over a few bricks is a good idea. Both preposed and postposed elements can also be discourse new as in But a fly in the ointment is inflation. These two elements can also be discourse old as in Racing with him on the near-side is Rinus. The dominant occurrence of the PI in the spoken texts also supports the view that the balance (or scene-setting) in information structure is the main trigger for the use of the PI construction. After being exposed to the real data and in-depth syntactic as well as informationstructure analysis of the PI construction, it is proved that the class students have had a farmore clear understanding of the construction in question and have realized that grammar does not mean to live on by itself but tightly interacts with other important grammatical components such as information structure. The study directs us toward both a datadriven and interactive grammar teaching.

A Case of Dissection and Resuture Performed at the Department of Korean Medicine for Excessive Granulation Tissue Caused by Suturing Failure (봉합 실패로 발생된 과다 육아조직에 대해 한의과에서 시행한 절제 및 재봉합 증례)

  • Eun-na Heo;Kang Kwon;Hyung-Sik Seo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.4
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    • pp.181-186
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    • 2023
  • Objectives : The purpose of this study is to report case of hypergranulation tissue that occurred after laparotomy and dissected by CO2 laser. Methods : A 72-year-old female had hypergranulation tissue on the epigastrium. Local anesthesia was achieved with bufonis venenum pharmacopuncture. The CO2 laser was used for dissection. After removal of granulation, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were performed. Yeonkyopaedok-san were administered for 7 days and the suture was removed after 14 days. At last, saengkigo was applied. Results : Hypergranulation tissue sized 1.0×1.0×1.0cm was clearly removed. Including excessive growing of granulation tissue, adverse effects were not reported until the clear skin adhesion. Conclusions : Hypergranulation tissue was surgically removed and sutured completely without any complications by using pharmacopuncture, oral herbal medicine and ointment that have anti-inflammatory effects and wound healing. Through this study, it is hoped that surgery including suture will be actively performed in more diverse diseases in the Korean medicine community.

Trends in Domestic and International Clinical Research on Korean Medicine Treatments for Triangular Fibrocartilage Complex Injury (삼각섬유연골 복합체 손상의 한의학 치료에 대한 국내외 임상 연구 동향)

  • Sang-Min Park;Tae-Gyeong Kwon;Jee-Hoon Baek;Min-Joo Lee;Sae-Rom Choi;Jee-Yeun Choi
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.71-83
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    • 2024
  • Objectives The purpose of this study is to analyze the trends in domestic and international clinical research on the Korean medicine for triangular fibrocartilage complex (TFCC) injuries and to contribute to future domestic research. Methods In this study, clinical studies on TFCC injuries treated with Korean medicine were searched through databases such as Research Information Sharing Service, ScienceON, DBpia, China National Knowledge Infrastructure, PubMed, Medline, and Embase. Fifteen clinical studies were selected, of which publication years, intervention methods, assessment tools, and various other factors were analyzed, including potential side effects. Results Among the selected 15 studies, total of 13 intervention methods were used. Electroacupuncture was the most frequently used method (40%), followed by herbal medicine (33%), acupuncture (26.7%), chuna manual therapy (26.7%), pharmacopuncture (20%), acupotomy (13%), herbal ointment (13%), hot medicinal compress therapy (13%) and etc. Most studies showed that Korean medicine treatments effectively alleviated TFCC injuries, with visual analogue scale being the most commonly used assessment tool. Conclusions Korean medicine treatments for TFCC injuries appears to be effective; however, further research is needed to enhance understanding. Large-scale clinical trials comparing the efficacy of Korean medicine treatments, along with investigations into side effects and recurrence rates are necessary. By doing so, the safety and efficacy of Korean medicine treatments for TFCC injuries can be further established.

Development of Nursing Costs by Nursing Activities in Clinical Nurse Specialist (전문간호사 간호행위에 관한 간호수가체계 개발)

  • Kim, Yoon-Hee;Lee, Hyang-Yeon;Han, Sang-Sook;Shin, Hye-Sook;Lee, Myung-Hee;Kim, Sook-Neoung;Lee, Hye-Jin;Kim, Hye-Sook;Choi, Hyes-Sun
    • Journal of East-West Nursing Research
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    • v.13 no.2
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    • pp.197-207
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    • 2007
  • Purpose: This study was carried out to deveop nursing costs and to substantiate the application of appropriate activity-based nursing costs for the current clinical nurse specialists. Method: The study sample was a group of 8 home health care team of the tirtiary Hospital in Korea. The data was collected from September 2003 through December 2004. The statistical analysis was done by SPSS PC 11.0 program and calculated mean and the standard deviation. In Lee(2003)'s nursing activity analysis, nursing activities were classified into two major classification, 19 domains and 70 activities. Each activities was calculated using its work validity, physical effort, psychological effort, stress as a intensity, and the necessary time. The simple work costs was calculated the work wage per minute and the necessary time. The work load intensity was calculated using the work wage per minute and the necessary time work load intensity/100. Results: In this study, the work wage was 283 won per minute. The work validity ranged from 2.71-4.00. The highest simple work cost/work load intensity cost was 12,735won/47,374won for research activity, 10,700won/27,499won for bedsore care, and 9,727won/35,114won for deathbed care. The lowest simple work cost/work load intensity cost was 2,123won/2,038won for intramuscular injection, 2,210won/2,166won for hypodermic injection, and 2,210won/1,547won for a application of medicine(or ointment or cream). Conclusions: It revealed that the nursing cost should be considered validity, physical effort, psychological effort, stress as a intensity, and necessary time. Therefore, It is necessary to calculate nursing cost systematically based on activities.

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Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

  • Park, Shin-Young;Lee, Hyo-Jung;Kim, So-Hyun;Kim, Sung-Beom;Choi, Yong-Hoon;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Periodontal and Implant Science
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    • v.48 no.4
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    • pp.213-223
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    • 2018
  • Purpose: Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment. Methods: The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed. Results: In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes. Conclusions: The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.

Effects of Lavender, Lemon and Eucalyptus Essential Oil on Th2 related Factors of DNCB-induced Atopy dermatitis in NC/Nga Mice Model (라벤더, 레몬, 유칼립투스 혼합 에센셜오일이 아토피 피부염 동물 모델의 Th2 관련인자에 미치는 영향)

  • Kim, Hyeon-Ah;Yun, Mi-Young;Song, Hyang-Hee;Cheong, Kwang-Jo;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.13 no.1
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    • pp.53-61
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    • 2010
  • Purpose : To investigate the effects of the lavender, lemon and eucalyptus oil mixture on the atopy dermatitis skin lesions induced on NC/Nga Mice by dinitrochlorobenzene (DNCB). Material and Method : For this purpose, we fabricated the oil mixture blending three essential oils (lavender, lemon, eucalyptus : ELL) with one carrier oil (jojoba) and apply it on the atopic dermatitis skin lesions of NC/Nga Mice. Atopic dermatitis in NC/Nga Mice was induced by DNCB treatment on the dorsal skin of mice for 8 weeks. The mixture of ratio of each essential oil drop was 1 (eucalyptus) : 2 (lemon) : 2 (lavender) and this mixture was blended with jojoba oil 50ml (0.025%). The ELL-ointment was supplied for 8 weeks. We evaluated the effects of ELL on cell viability of mouse lung fibroblast, clinical skin features and severity, the level of serum Immunoglobulin (Ig) E & Ig G1, Interleukin (IL)-4, IL-13 and Interferon (IFN)-$\gamma$. Results : ELL showed safety on the cell viability of mouse lung fibroblast compared with control group. The cell viability was measured by SRB method. The effects of ELL on clinical skin features and severity in DNCB-induced dermatitis model of NC/Nga mice was significant compared with control group. EEL also showed significant effects on clinical symptom score compared with control group. Serum IgE & IgG1 level and development of atopy dermatitis skin lesions were evaluated. Serum IgE & IgG1 production was significantly down-regulated in EEL group compared with control group. ELL also down-regulated the levels of IL-4 and IL-13, and up-regulated the level of IFN-$\gamma$ compared with control group significantly. Conclusion : ELL was effective on atopy dermatitis by modulating Th2 related factors.