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Treatment of Venous Stasis Ulcer with $3M^{TM}$ $Coban^{TM}$ 2 Layer Compression System: A Case Report (두겹 압박방식 $3M^{TM}$ $Coban^{TM}$을 이용한 울혈성 정맥궤양의 치료: 증례보고)

  • Chu, Ho-Jun;Son, Dae-Gu;Kim, Jun-Hyung;Han, Ki-Hwan;Kim, Hyung-Tae
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.699-702
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    • 2011
  • Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

A study on the Occurrence of the Stroke Patients (뇌졸중 환자의 발생특성에 관한 연구)

  • Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.2 no.1
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    • pp.21-33
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    • 1990
  • The purpose of this study is to investigated the occurrence properties of the cerebrovascular accidents. Clinical observations were done 252 cases, were carried from June, 1989 to May, 1990 at 4 general hospital in Taegu, Korea. The following results have been obtained ; 1. Among the 252 cases of cerebrovascular accidents, males was noted in $51.6\%$ and females in $48.4\%$. The ratio between males and females was 1.1 : 1 in whole groups of cerebrovascular accidents, and in aging distribution, it was showed variety distribution in age groups, fifties, sixties and forties were in order of frequency, particulary, more than half was shelved from 50 to 69. 2. Among the 252 cases of cerebrovascular accidents, cerebral hemorrhage was rioted in $64.3\%$, cerebral infarction in $25.8\%$, cerebral thrombosis in $6.3\%$, subarachnoid hemorrhage in $2.4\%$ and cerebral embolism in $1.2\%$. 3. In distribution of academic career, high school level was noted in $37.7\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$ arid college level in $14.7\%$. 4. In distribution of occupation, office worker was noted in $21.8\%$, housewife in $20.2\%$, the others in $19.1\%$, physical laborer in $18.3\%$ and inoccupation in $18.3\%$. 5. In seasonal distribution, spring was noted in $34.9\%$, winter in $32.5\%$, autumn in $20.3\%$ and summer in $12.3\%$. 6. Among the preceding diseases at the onset of cerebrovascular accidents, hypertension was noted in $51.6\%$, no preceding disease in $20.2\%$, other disease in $10.3\%$ and diabetes mellitus in $9.5\%$ and cardiovalvular disease in $6.0\%$. 7. In systolic blood pressure on admission, 160-199mmHg was noted in $32.2\%$, 200-239mmHg in $23.4\%$, 140-159mmHg in $19.4\%$, below 140mmHg in $16.3\%$, and above 240mmHg in $8.7\%$, While, in diastolic blood pressure, above 130mmHg noted in $24.6\%$, below 90 mmHg in $17.1\%$, 120-129mmHg in $13.1\%$ and was 90-99mmHg in $11.1\%$. 8. In major predisposing factors of patients, emotional stress was noted in $20.2\%$, physical action in $17.9\%$, rest in $16.9\%$, while sleeping in $10.7\%$, drinking in $9.9\%$ and defecation in $7.9\%$. 9. In distribution of affected side, left was noted in $48.4\%$, right in 42.1 and both $9.5\%$. 10. In rates of recurrent cases, first attach was noted in $79.0\%$, 1st recurrence in $17.0\%$, 2nd recurrence in $3.6\%$ and 3rd recurrence in $0.4\%$.

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The Management of Spontaneous Pneumothorax -Clinical Review in 451 Cases- (자연기흉의 임상적 고찰(451례))

  • 오태윤;장운하;배상일
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.374-379
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    • 1998
  • From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax(SSP) was 53.1 years. 330 out of 451 patients(73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients(72%), and 24 patients(19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.

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Bronchoplastic Procedures in Patients with Benign Bronchial Stenosis ann'Obstruction -Review of 13 cases- (양성 기관지 협착 및 폐쇄환자에서의 기관지 성형술 -13례 보고-)

  • 조건현;조민섭
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1366-1372
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    • 1996
  • Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

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Weathering of Rock Specimens Exposed to Recurrent Freezing and Thawing Cycles (동결-융해 풍화에 의한 암석 물성 변화 양상과 추정에 관한 연구)

  • Ryu, Sung-Hoon;Song, Jae-Joon
    • Tunnel and Underground Space
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    • v.22 no.4
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    • pp.276-283
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    • 2012
  • Changes in rock properties due to freezing and thawing cycles ranging from $-20^{\circ}C$ to $10^{\circ}C$ were checked for the typical Korean rocks: granite (weathered), limestone, sandstone, tuff, shale and basalt. The porosity, seismic velocity, shore hardness and specific gravity were measured every 10 cycles for each type of rock up to 40 cycles. The specific gravity was rarely changed. Granite (w), shale and basalt decreased gradually in their shore hardness and seismic velocity values, these values for limestone, sandstone and tuff changed only a very little. The porosity increased in the granite (w), shale and basalt, whereas in the others it did not change. Due to the low tensile strength with high porosity, granite (w), shale and basalt were susceptible to the F-T cycles. A linear regression equation was calculated based on the experiment results according to properties and types of rock. The relationship between the freeze-thaw sensitivity (=initial porosity/initial tensile strength) and the coefficients of the regression equation was examined. With additional experimental data, the coefficients of the regression equation can be estimated using the F-T sensitivity. This makes it possible to predict the properties of rock as affected by freeze-thaw weathering by only measuring the initial properties without knowledge of the regression equation coefficients for each type of rock.

Occurrence of tertian malaria in a male patient who has never been abroad (외국 여행 경력이 없는 남자 환자에서 발병한 삼일열 말라리아 1예)

  • 채인호;임건일
    • Parasites, Hosts and Diseases
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    • v.32 no.3
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    • pp.195-200
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    • 1994
  • Malaria is estimated to have a worldwide incidence of more than 100 million clinical cases and approximately 1 miuion deaths per year. Korea, although previously tnlown as an endemic area of tertian malaria (Pzosmonin vivax), has been considered free from malaria as there had been no report on indigenous cases since 1984. Recently, however, we experienced an indigenous case of P. viuax infection in a young man who had never been abroad. The patient was a 23-year-old Korean soldier with 18-day history of recurrent fever and chill lasting 4 to 8 hours on alternative days since mid-July 1993. He had lived in Changwon, Hyongsangnam-do, before entering barracks located in Paiu-gun, Kyonggj-do on Jne 1992, and had never been out of Korea. He had no history of blood transfusion nor parenteral use of drugs. The peripheral blood smears showed typical ring forms, trophozoites, and gametocytes of p. uiuox, in addition to mild anemia and thrombocytopenia. After confirmation of the diagnosis, he was treated with hydroxychloroquine and primaquine. Follow-up blood smears no more revealed malaria parasites. It is not certain whether the present case is due to a resurgence of indigenous malaria or a secondary infection from introduced mnuia. Whichever the source of infection the domestic occurrence of mnuia cycle in Korea should be a warning sign in public health point of view.

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The Recurrent Pregnancy Loss Associated with a Female Carrier of a Structural Chromosome Rearrangement (염색체 구조적 이상을 가진 산모의 재조합에 의한 태아의 비정상 핵형분석결과의 증례보고)

  • Lee, Soo-Min;Go, Sang-Hee;Jo, Soo-Kyung;Park, So-Hyun;Moon, Soo-Jin;Lee, Dong-Suk;Kim, Ki-Chul;Hwang, Do-Yeong
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.156-159
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    • 2010
  • Inversion, one of the balanced rearrangements, usually does not lead to phenotypic abnormalities; all genetic information exists in the proper amount, merely in a different order or in an abnormal location. However, offspring of an inversion carrier is at risk of chromosomal imbalance because an inversion loop can be formed during crossing-over of the paternal and the maternal chromosomes in meiosis. We report a 38-year-old woman with inversion and balanced translocation and her fetus with unusual rearrangement causing chromosomal imbalance. We performed conventional cytogenetic analysis, MLPA, and subtelomeric FISH in the cells of the embryo. The results showed that the distal portion of chromosome 13q was added to the terminal portion of chromosome 9p during crossing-over. Therefore, the final karyotype of the fetus was 46,XY,rec(9)t(9;13)(p22;q32)inv(9)(p12q13)mat, confirmed using molecular-cytogenetic analyzing tools.

Pedicled Deep Inferior Epigastric Perforator Flap for Treatment of Dystrophic Epidermolysis Bullosa-Associated Squamous Cell Carcinoma in the Groin - Case Report - (심부하복벽동맥 천공지 유경 피판을 이용한 이영양성 수포성 표피박리증에 합병된 서혜부 편평 세포 상피암의 치료 - 증례 보고 -)

  • Kim, Kyung-Pil;Kim, Ji-Hoon;Kim, Eui-Sik;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.97-100
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    • 2010
  • Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.

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Estimation of Sodium Hydroxide Waste Origin-Destination Matrices for Preventing Hazardous Material Transportation Disasters

  • Kim, Geun-Young;Jung, Tae-Hwa;Kim, Sang-Won
    • Journal of the Korean Society of Hazard Mitigation
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    • v.9 no.1
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    • pp.73-79
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    • 2009
  • Hazardous materials (HazMats) are substances that are flammable, explosive, toxic, or harmful, if released into the environment. Since the transportation of HazMats increases in many developed countries, HazMat transportation has the key function in the process of HazMat usage to trace information of production, storage, shipment, usage, and waste disposal. The Korean Ministry of Environment (KMOE) and the National Emergency Management Agency (NEMA) have developed many laws, regulations, and standards for hazardous materials. However, the Korean HazMat laws, regulations, and standards do not guarantee accurate information of HazMat origin-destination (O-D) shipments, though the HazMat O-D movement is the critical information in safety and security of HazMat transportation. The objectives of this research are: (1) to investigate emerging and recurrent issues in Korean HazMat transportation, and (2) to develop the estimation method of O-D matrices for hazardous materials under limited data sets. The sodium hydroxide waste shipment among forty candidate HazMats is selected as the sample research case. The growth-factor method is applied to estimate the 2005 O-D matrix of sodium-hydroxide waste shipment. The column-and-row factoring process is used to calibrate the estimated sodium-hydroxide O-D matrix. The result shows the applicability of the O-D estimation process for hazardous materials. The Sodium Hydroxide Waste Origin-Destination Matrix is obtained to trace routes and paths of the Sodium Hydroxide transportation.

Aspergillosis of Central Nervous System (중추신경계의 Aspergillosis)

  • You, Seung-Hoon;Lee, Jung-Il;Nam, Do-Hyun;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Park, Kwan;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.896-902
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    • 2001
  • Objectives : Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures. Material and Methods : We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS. Results : Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months. Conclusion : Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.

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