Kim, Mi-Sun;Kim, Chul-Han;Lee, Yong-Sek;Kang, Sang-Gue;Tark, Min-Sung
Archives of Plastic Surgery
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v.37
no.6
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pp.831-834
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2010
Purpose: Congenital absence of the vagina is a rare case. It occurs as a result of Mullerian duct aplasia or complete androgen insensitivity syndrome. The reconstructive modality includes skin graft, use of intestine and various methods of flap. We report a patient who underwent vulvoperineal fasciocutaneous flap to reconstruct congenital absence of the vagina, while the external genitalia and ovaries are normal. Methods: A 26-year-old woman presented with vaginal agenesis. Under general anesthesia, a U-shaped incision was made between the urethral meatus and the anus. The new vaginal pocket was created up to the level of the peritoneal reflection between the urinary structures and the rectum. Next, the vulvoperineal fasciocutaneous flaps were designed in a rectangular fashion. Flap elevation was begun at the lateral margin which the adductor longus fascia was incised and elevated, and the superficial perineal neurovascular pedicle was invested by the fascial layer. The medial border was then elevated. A subcutaneous tunnel was created beneath the inferior of the labia to rotate the flaps. The left vulvoperineal flap was rotated counterclockwise and the right was rotated clockwise. The neovaginal pouch was formed by approximating the medial and lateral borders. The tubed neovagina was then transposed into the cavity. Results: In 3 weeks, the vaginal canal remained supple After 6 weeks, the physical examination showed normalappearing labia majora and perineum with an adequate vaginal depth. A year after the operation, the patient had a 7 cm vagina of sufficient width with no evidence of contractures nor fibrous scar formation. The patient was sexually active without difficulty. Conclusion: Although many methods were described for reconstruction of vaginal absence, there is not a method yet to be approved as a perfect solution. We used the vulvoperineal fasciocutaneous flap to reconstruct a neovagina. This method had a following merits: a single-stage procedure, excellent flap reliability, the potential for normal function, minimal donor site morbidity and no need for subsequent dilatation, stents, or obturators. We thought that this operation has a good anatomic and functional results for reconstruction of the vagina.
A castrated male Yorkshire Terrier dog was presented for urinary incontinence and constipation. On physical examination, the dog showed difficult urination. There were no neurological abnormalities and no bacterial detection on urinalysis. Rectal examination revealed a regular, normal-sized prostate. Urethral catheterization was performed easily. Excretory urography and retrograde positive contrast urethrocystography showed displacement of the urinary bladder to the intrapelvic region. There was no evidence of an ectopic ureter. A tentative diagnosis of urethral sphincter mechanism incompetence accompanied with a pelvic bladder was made. Cystopexy was decided to place the urinary bladder to its normal position. The neck of the urinary bladder was anchored to the body wall and prepubic tendon using mattress sutures. Additional sutures were placed to appose the lateral part of the urinary bladder and abdominal wall. A simple interrupted suture was placed to tack the apex of the urinary bladder on the abdominal incision line. A urinary catheter was placed in the urinary bladder to provide post-operative evacuation. The catheter was removed when the dog was able to urinate with minimal straining at 3 days post-operatively. The owner reported that the dogs showed normal urination without straining at 3 days after the catheter was removed. Excretory urography revealed that the urinary bladder was located on its normal position at 2 months post-operatively. Subsequent communication with the owner by telephone revealed that the dog was in good urination at 3 years 11 months post-operatively.
A 9-month-old female Korean short hair cat weighing 2.2 kg presented for evaluation of a two-week history of obstipation. The owner reported that the cat sustained pelvic fractures 4 months previous to the onset of fecal tenesmus. On physical examination, fecal tenesmus was observed and restriction of the movement of the right coxofemoral joint was evident. Rectal palpation revealed narrowing of the pelvic canal with a hard bony protuberance at the bilateral acetabulum and pubic bones. Radiographs revealed a distended colon with feces and narrowing of the pelvic canal with abnormal structure of the pelvic bone. Conservative management consisting of stool softeners and a warm water enema was instituted; however, there was no improvement in obstipation. Partial iliac, ischial, pubic, and acetabular ostectomies were performed. Postoperative radiographs and rectal palpation revealed the enlarged pelvic canal. Stool softeners (5 ml orally twice daily) was administered following surgery for 14 days and then tapered down to 2.5 ml for 14 days. A warm water enema was performed twice postoperatively. At examination 14 days postoperatively, no problems with defecation and gait were reported. There was no evidence of obstipation and lameness of the left pelvic limb 5 months postoperatively.
Objectives: The purpose of this study was to research learning based on brain science and the learning methodology of Korean Medicine according to disparity of age. Through this, the study aimed to provide a guideline to related Korean Medicine treatments as well as the common nurturing/educational institutions. Methods: All journals and dissertations on brain science based learning methods studied in Korea to date that could be found in the National Assembly Library and the RISS were implemented in the analysis. The terminology used for search was as follows: 1st search, 'Brain'; 2nd search, 'Learning', 'Education'; 3rd search, 'Baby, 'Infant', 'Child'. For the learning methodology of Korean Medicine according to disparity of age, the related contents were extracted from Donguibogam and Liuyi, Sasang constitutional medicine. Results: A total of 30 studies, were collected as data. In the baby stage, the development and myelination of brain neurons are accelerated by experience and learning, highly influenced by social, cognitive and emotional movement. In infancy, the frontal lobe actively develops, so education for development of the prefrontal cortex is suggested. The brain of the infant at this stage can be developed by arts and physical education. In the child stage, the parietal and temporal lobe develop actively. Thus, programs to stimulate brain activity including brain respiration would be helpful in enhancing learning ability, concentration, etc. As evidence for learning and nurturing methodology according to disparity of age from Korean Medicine prospective, the following are listed: Location and time for sexual intercourse before pregnancy, stabilization during pregnancy, baby nurturing methods for nurturing from Donguibogam. Also Liuyi and Sasanag constitutional medicine can be the learning methodology according to disparity of age. And there are acupuncture points on each head section according to age in Donguibogam. Conclusions: Studies on 'brain-science based learning' are continuously being conducted. Based on these studies, diverse new brain-science based learning will be developed in the future. There is also a need to develop the learning methodology of Korean Medicine according to disparity of age in a more systematic and diverse way.
This study was conducted for the purpose of identifying the trends of nursing research and to suggest the direction of future research in the graduate levels of the study. The data was collected from 469 abstracts of master's and doctoral rapers from three graduate schools, one in Nursing, another in Education, and the other in Public Health Graduate College. The results of the study are as follows: The number of research was increased from 102 to 286 between the 1970 s and 1980's. The most frequently employed research design was descriptive studies in the master's level, but there was some balance between descriptive and experimental studies along with some qualitative approaches in the doctoral thesis. Patients were the most often studied sample group reaching 42% of the cases, though it Was noted that there was steady shift: toward the non-ratient population. With this shifting of the study sample, the places of the study also have showed some changes moving toward community. The most widely studied area was in clinical practice. Chronic illness, preventive, and health promoting areas of studies also increased in numbers. However, most of them were at the descriptive level of phenomena and only a few were concerned with cost/effective measures of nursing intervention. The number of variables studied repeatedly more than five times was 43. They were not only physical but also psychosocial aspects which imply the efforts to incorporate the whole person in nursing discipline. However, most researches with repeated studies showed little relation to previous studies, and thus little accumulation in knowledge. There was also little evidence of linkage to nursing theory in most studies of master's level. For the doctoral rapers, 17 out of 51 rapers showed specific theories related to the researches. Based on the above findings, the following suggestions were made. Various research design should be employed including case studies, historical studies, as well as qualitative approaches. There should be more effort to establish linkage between theory and research. The areas needing more attention are Korean Nursing History, Ethics in our Culture, Cost/Effective Measures of Nursing Intervention, Concept and Thory Development, and the Strategies for the Implication of the Research Results in clinical practice.
This writing establishes identity of JinSeBaek, a male protagonist from a classical novel Hajinyangmunrok, through examining his relationship with a female character named HaOkJu. The character JinSeBaek was analyzed with attachment theory. JinSeBaek is a type of character who openly expresses his emotions. The evidence that JinSaeBaek falls in love with HaOkJu at a first sight was mainly shown through his physical affection with her. After the breakup, JinSeBaek expresses sadness, depression, and anger, as well as sheds tears. Although JinSeBaek repeatedly breaks up and gets back together with HaOkJu, JinSaeBaek consistently shows his desire to be with HaOkJu. Expressing true emotions was not ideal characteristic for men in this era. JinSaeBaek develops attachment to HaOkJu after he loses his parents, whom he has previously developed attachment to, but repeated break ups with HaOkJu leads to separation anxiety. Although his separation anxiety is caused by HaOkJu, it is also HaOkJu who can resolve the anxiety. The fact that JinSaeBaek honestly expresses his emotions and develops abnormal attachment to woman makes JinSaeBaek unique from other male protagonists. A character like JinSaeBaek is not common in other fictional novels or romance novels as well. Thus, JinSaebaek is claimed to be extraordinary character in literature.
Along with the well-established evidence on the negative effect of social isolation on physical mental health and mortality, increasing attention has been paid to multi-dimensional nature of social isolation. In this study, the main effect and interaction effect of objective and subjective social isolation on heterogeneous age cohort related to the onset of dementia, which is becoming a social problem due to rapid aging of health issues, was examined through binary logistic regression analysis. Data came from the first wave of Korean Social Life, Health and Aging Project (KSHAP) (N= 814). Findings showed 1) in the young-old, objective isolation was a significant on the incidence of dementia, 2) in the old-old, subjective isolation increased the risk of dementia. In summary, the relative influence of objective and subjective social isolation related to the incidence of dementia varies depending on the young-old and old-old. On the other hand, the interaction effect of objective and subjective social isolation on dementia was not significant in both the young-old and old-old. Based on the findings, we discussed implications and suggestions for future research and relevant policy and program development(dementia-friendly communities) for ameliorating objective and subjective social isolation.
Archaeogenetics is an academic discipline that aims to establish scientific facts of human history by integrating ancient DNA analyses with archaeological and anthropological evidence. After ancient DNA research was initiated about 30 years ago, it has been innovated so rapidly that the range of analysis has been extended toward the whole genome sequence of ancient genomes in recent 10 years. By this development, researchers have been able to study in detail the origins and migration patterns of hominin species and ancient human populations by approaches of evolutionary genetics. This study has reviewed main principles of the archaeogenetic analysis and the current trends of ancient genome studies with recent achievements. While sampling techniques and statistical analyses have been improved, typical research methods have been established by the findings on hominins and ancient western Eurasia populations. Recently, archaeogenecists have been applying the methods to studying those in other geographical areas. Nonetheless, there is still the lack of ancient genome research about populations in Eastern Asia including the Korean peninsula. This review ultimately aims to predict possibilities and promise of future ancient genome studies of ancient Korean populations.
This systematic review was performed to investigate relationship between sarcopenia and cognitive function among community-dwelling older adults. Studies which reported prevalence rates of sarcopenia in community-dwelling older adults, relationships between sarcopenia and cognitive dysfunction, or effective interventions in alleviated symptoms of sarcopenia were selected. Of 43 studies reviewed, prevalence rate of sarcopenia ranged from 2.5-42.4% in 25 studies, and 4 studies revealed a significantly positive correlation between sarcopenia and cognitive dysfunction. Among 12 randomized-control trials (RCTs), exercise intervention was used in 2 studies; nutrition intervention in 6; and 4 studies included both the exercise and nutrition interventions. All interventional studies reported positive effects on muscle mass, muscle strength, or physical function. However, only 6 studies met the high quality criteria of Risk of Bias, and there was no study which evaluated cognitive function as an outcome measure. Therefore, this study draws attention to the lack of high-quality RCTs and exclusion of cognitive function as an outcome measure in the research of sarcopenia. A comprehensive and sustained system including standardized sarcopenia screening, assessments of cognitive functioning, and evidence-based intervention programs is needed in order to prevent and manage sarcopenia amongst older adults in the community.
Park, Sung Chul;Park, Sang Gu;Kim, Sung Tae;Kim, Jae Hwan;Jwa, Yong-Joo
Journal of the Korean earth science society
/
v.40
no.1
/
pp.46-55
/
2019
In this study, we investigated the stone materials used in the Woldae of Kwanghwamun gate to estimate their provenances. The Woldae was partly reconstructed in 2010 using red-colored original stone and greyish new stone. We carried out geological survey in Mt. Bukhan (Bukhansan) and Mt. Surak (Suraksan) to estimate the source of stone, where red-colored granitic rocks are widely distributed. Though the petrographical features of the granitic rocks from the surveyed area are quite similar, there exists a slight variation of magnetic susceptibility and color index of the rocks: the granitic rocks from Mt. Surak have higher value of magnetic susceptibility and clearer reddish feature. A series of evidence, such as historical records, stone cutting traces and petrographical features, for the source of stone materials used in the Woldae tells that Mt. Surak would have been the provenance for the stone materials used in the Woldae. We also conducted a nondestructive test to examine the physical property of the rocks. The original stone shows low compressive strength (147 MPa) due to the weathering, whereas the rock in Mt. Surak has higher compressive strength (244 MPa) capable of being used as building materials. If there were any difficulties to use the granitic rocks in Mt. Surak, some granitic rocks that have similar petrological characteristics, such as Changsu stone and Yeongjung stone from the Pocheon area, could be used as building material instead.
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