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Single-Stage Reconstruction with Titanium Mesh for Compound Comminuted Depressed Skull Fracture

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.631-639
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    • 2020
  • Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

Initial Motor Unit Discharge Pattern in Patients with Stroke (뇌졸중 환자에서 운동단위의 초기 방전 양상)

  • Lee, Sang-Moo;Bae, Jae-Chun
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.12-15
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    • 2002
  • Background : Changes in firing pattern and in the recruitment order of single motor unit(MU) have been claimed to be characteristic of central motor lesions, and a reduced firing rate was found in upper motor neuron lesions. But these findings have been rarely studied before in Korea, so we studied initial MU recruitment pattern in stroke patients with hemiparesis. Methods : We studied six patients(3 men and 3 women) whose mean age was $60.6{\pm}7.4$ years. A mean $20.6{\pm}16.2$ months had elapsed since the stroke. To compare the initial MU activation patterns in proximal and distal segments of paretic limb with their contalateral unaffected counterparts, we studied the onset and recruitment intervals in biceps brachii(BB) and first dorsal interossei(FDI) muscles in paretic and healthy arms. In a single muscle we examined from 5 to 10 individual MUs. And in a single motor unit, both the onset interval and the recruitment interval was examined. Results : The mean onset interval in paretic limb was significantly(p<0.05) longer than unaffected limb at proximal and distal location: BB $118.5{\pm}17.8$ msec vs $96.1{\pm}8.3$ msec(n=58); FDI $125.8{\pm}16.7$ msec vs $101.5{\pm}17.2$ msec(n=38). The mean recruitment interval in paretic limb was also significantly(p<0.05) longer than unaffected limb: BB $87.7{\pm}14.9$ msec vs $73.4{\pm}11.5$ msec(n=53); FDI $96.3{\pm}16.4$ msec vs $87.7{\pm}14.1$ msec(n=38). Conclusion : The first recruited MU had a lower baseline firing rate and the second recruited motor unit potential appeared earlier in paretic than in healthy muscles. And these findings may explain one of the reasons for paresis in patients with stroke.

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Selection of Reference Equations for Lung Volumes and Diffusing Capacity in Korea (우리나라 성인 폐용적 및 폐확산능 정상예측식의 선정)

  • Song, Eun Hee;Oh, Yeon Mok;Hong, Sang Bum;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Kim, Tae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.218-226
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    • 2006
  • Background: The lung volume and diffusing capacity are influenced by ethnicity. However, there are no equations for predicting the normal lung volume in the adult Korean population, and there is only one equation for diffusing capacity. The aim of this study is to select the most suitable reference equation for the Korean population. Method: 30 men and 33 women at Hanyang University Guri Hospital, and 27 men and 34 women at Asan Medical Center in healthy nonsmoking adults were enrolled in this study. The subject's age, gender, height, weight, lung volume by plethysmography, and diffusing capacity by a single breathing method were obtained. The most suitable equation with the lowest sum of residuals between the observed and predicted values for lung volume and diffusing capacity was selected. Result: At Hanyang University Guri Hospital, the equations with the lowest sum of residuals in the total lung capacity were ECSC's equation in males (sum of residual: 0.04 L) and Crapo/Morris's equation (-1.04) in women. At the Asan Medical Center, the equations with the lowest sum of residuals in the total lung capacity were Goldman/Becklake's equation in males (sum of residual: -2.35) and the ECSC's equation -4.49) in women. The equations with the lowest sum of residuals in the Diffusing capacity were Roca's equation in males (sum of residual: -13.66 ml/min/mmHg) and Park's in women (25.08) in Hanyang University Guri hospital and Park's equation in all cases in the Asan Medical Center (male: -1.65, female: -6.46). Conclusions: Until a reference equstion can be made for healthy Koreans by sampling, ECSC's equation can be used for estimating the lung volume and Park's can be used for estimating the diffusing capacity.

A Comparative Understanding of Health Concepts

  • Lee, Mi-Kyung;Duncan Boldy;Kim, Kong-Hyun-Kim
    • Korean Journal of Health Education and Promotion
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    • v.1 no.1
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    • pp.75-94
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    • 1999
  • This study explored the understanding of health of people from Korea. Data were collected from a total of eighteen focus groups: Koreans (living in Korea), Korean-Australians, Korean-Americans and Australians. The data were analysed using QSR NUD*IST. The meaning of health varied among people and it was related to differences in age, culture, gender, marital status and perceived health status of individuals. However, there were several themes common to everybody. All groups included aspects of physical, mental, emotional (and spiritual), environmental and social dimensions in their definitions of health. All young single groups placed more emphasis on physical and lifestyle factors whereas mental and emotional aspects and social responsibility were more associated with health among older married groups. Young women in all cultures felt social pressure to 'look good' and the media was perceived as responsible. Men in general associated health with societal roles and social competition. Health was strongly associated with the economy and economic stability for all Korean groups reflecting the recent adverse economic situation in Korea. This information will be of value to health professionals to provide more effective health services and health promotion programs for clients of Korean ethnicity living in multicultural societies like Australia and America.

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Histopathological Evaluation of Urothelial Carcinomas in Transurethral Resection Urinary Bladder Tumor Specimens: Eight Years of Single Center Experience

  • Koyuncuer, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2871-2877
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    • 2015
  • Background: Urothelial carcinoma (UC) is a malignant neoplasm that most commonly occurs in the urinary bladder. The primary aim of this study was to evaluate the clinicopathologic features, recurrence and progression in patients with bladder urothelial cancer. Materials and Methods: The medical records of patients diagnosed with UC in the state pathology laboratory between January 2006 and July 2014 were retrospectively included. Carcinomas were categorized according to age, gender, histologic grade, tumor configuration, pathologic staging, recurrence status, and progression. Results: A total of 125 (113 men, 12 women) patients were examined. The mean age was 65.9 years and the male-to-female urothelial cancer incidence ratio was 9.4:1. Low-grade UCs were observed in 85 (68%) and high-grade in 40 (32%). A papillary tumor pattern was observed in 67.2% of the UCs. Cases were classified with the following pathological grades: 34 (27.2%) cases of pTa, 70 (56%) of pT1, and 21 (16.8%) of pT2. Recurrence occurred in 27 (21.6%) patients. Ten progressed to a higher stage (pT1 to pT2), and three cases to higher grade (low to high). We also analyzed the results separately for 70 (56%) patients 65 years of age and older. Conclusions: With early detection and diagnosis of precursor lesions in older patients, by methods such as standard urologic evaluation, urinary cytology, ultrasound scanning and contrast urography, and cystoscopy, in addition to coordinated efforts between pathologists and urologists, early diagnosis may reduce the morbidity and mortality of patients with urothelial carcinoma.

An Analysis of the Premarital Preparation Education Program (결혼준비교육 프로그램의 분석)

  • Moon Sook-Jae;Jung Young-A;Yoon So-Young
    • Journal of Family Resource Management and Policy Review
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    • v.10 no.1
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    • pp.33-51
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    • 2006
  • Today, the Korean society is experiencing an increase in serious problems, such as child abuse, unmarried mothers, single mothers, which cannot be overlooked as simply trivial family matters. The increase in these problems is caused by the rapid change that has taken place within our society, which has emasculated the power of our traditional values and behavior patterns to cope with contemporary life styles. Premarital Preparation Education is starting to gain attention as a preventive measure that can overcome this serious family crisis. Although the importance of the Premarital Preparation Education program cannot be overemphasized, there are only few cases where engaged couples and unmarried men and women are exposed to this type of program and actually experience its benefits. In other words, there is an urgent need to revitalize and increase the effects of the Premarital Preparation Education Program. This research was conducted in order to find a way to revitalize and to increase the effects of the program, so that more and more people can participate and receive benefits from it. First, we have analyzed the program's contents and the current condition on how the program is actually conducted. Then we have compared real case examples of the program and analyzed the current situation and its problems.

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The Effect of 3-Dimensional Posture Correction Exercise Program Incorporating PNF Respiratory Muscle Strengthening Exercise on the Spinal Alignment and the Trunk Expansion in Patients with Idiopathic Scoliosis

  • Yoon, Sungyoung;Seok, Him;Heo, Jaeseok;Lee, Sangyeol
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.430-437
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    • 2021
  • Objective: The purpose of this study was to investigate the effect of 3-dimensional posture correction(3DPC) exercise program incorporating PNF respiratory muscle strengthening(RMS) exercise on spinal alignment and trunk expansion in patients with idiopathic scoliosis and the difference in intervention effect by type of idiopathic scoliosis. Design: Comparative study using paired t-test and analysis of variance measures. Methods: The subjects of this study were 5 men and 24 women diagnosed with idiopathic scoliosis with a Cobb angle greater than 10 degrees and less than 45 degrees. A 3DPC exercise program incorporating PNF RMS exercise was conducted twice a week for 1 hour per session for 6 weeks, and Cobb angle, Angle of trunk rotation, and trunk expansion were measured before and after the intervention. Results: After the intervention, Cobb angle and trunk rotation angle showed a statistically significant decrease, and trunk expansion showed a statistically significant increase. In the effect difference by type, there was a statistically significant difference in the angle of trunk rotation of the thoracic in 3C and Single Lumbar. Conclusions: In conclusion, it is thought that a 3DPC exercise program incorporating PNF RMS exercise can be effectively used in clinical practice to improve spinal alignment and trunk expansion in patients with idiopathic scoliosis.

Aortocoronary Bypass Surgery Concomitant with Cardiac Valve Replacement (심장판막 치환술을 병행한 관상동맥 질환의 수술)

  • Kim, Kyung-Hwan;Chae, Hurn;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.187-190
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    • 1994
  • Between March, 1989, and August, 1993, 10 patients underwent aortocoronary bypass surgery concomittant with cardiac valve replacement. They were 6 men and 4 women, the age ranging from 47 to 64. 7 patients underwent single valve replacement and 2 patients underwent double valve replacement, Another one patient underwent only CABG one year after valve replacement and he had no evidence of prosthetic valve failure. Total number of graft vessels were.15,14 were saphenous venous grafts and 1 was internal mammary artery graft. Dyspnea on exertion was frequent symptom and was found in all patients. 8 patients presented stable angina, only 1 patient presented postinfarct angina and another 1 patient presented no angina symptom. The graft was placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout operation. Postoperative course was uneventful and there was no hospital mortality, as was supported by many reports, it is our opinion that simultaneous valve replacement and aortotomy bypass graft does not increase the risk of cardiac valve replacement substantially.

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The Symbolic Meaning and Values Portrayed In Models' Characteristics in Fashion Advertisements

  • Kwon, Gi-Young;Helvenston, Sally I.
    • International Journal of Human Ecology
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    • v.7 no.2
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    • pp.29-41
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    • 2006
  • Various current events provide evidence that society is undergoing changes in perceptions of social relationships. Specifically, visual media in the form of advertisements can convey images which reflect society's values and concepts about role relationships. The purpose of this research was to examine ads in fashion magazines to determine what types of model roles and role relationships typically appear in fashion advertising which can mirror society's values. A content analysis was conducted of ads obtained from US Vogue and US GQ for the year 2002. Six kinds of roles/relationships were found: (1) Narcissism (representing self absorption), (2) sexually enticing opposite-sex relationships, (3) close/romantic same-sex relationships, (4) friend relationships, (5) family relationships, and (6) independent relationships. Of these, narcissism predominated, however, a small number of sexually provocative ads appeared as well as same-sex romantic relationships. Because sole (single) models were more typical, they also were examined to determine ways in which they relate to the audience. Characteristics examined included body presentation & pose, eye gaze, and facial expression. Direct eye gaze was the typical way to engage the audience. Gender differences were apparent: smiling was more typical of women, indifference for men. The symbolic meaning and values investigated from this research are the blurring of gender identity portrayed in homosexual imagery, family values, and the value of youth. The consistency of models' race in ads does not portray the diversity reflected in the demographic census.

Early Mobilization after Operative Treatment of a ruptured Achilles tendon (아킬레스건 파열에 대한 수술 후 조기 재활 치료)

  • Chung, Hyung-Jin;Park, Joon-Suk;Kim, Hyun-Ho;Park, Yong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.78-82
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    • 2003
  • Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

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