• Title/Summary/Keyword: sternum

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Deep sternal wound infections: Evidence for prevention, treatment, and reconstructive surgery

  • Schiraldi, Luigi;Jabbour, Gaby;Centofanti, Paolo;Giordano, Salvatore;Abdelnour, Etienne;Gonzalez, Michel;Raffoul, Wassim;di Summa, Pietro Giovanni
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.291-302
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    • 2019
  • Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.

Using the PNF Approach to Improve Respiratory Function in Patients with Cervical Spinal Cord Injuries (고유수용성촉진법을 이용한 호흡운동이 경수 손상환자의 호흡기능에 미치는 영향 : 증례보고)

  • Song, Gui-Bin;Kim, Jung-Bin
    • PNF and Movement
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    • v.12 no.2
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    • pp.115-121
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    • 2014
  • Purpose: The study aimed to examine the influence of PNF direct and indirect breathing treatments for patients with cervical spinal cord injuries who had breathing problems. Methods: For each cervical spinal cord patient, force vital capacity (FVC), peak expiratory flow, maximum phonation time (MPT), rib cage width, and VAS were measured pre-intervention and four weeks after post-intervention. The indirect method and the direct method were used for interventions. We treated patients with the indirect method using scapular anterior depression pattern, bilateral extensor pattern with rhythmic initiation, and a combination of isotonic. We treated patients with the direct method, applying pressure on the sternum and using rhythmic initiation (hold relax and stretch reflex) for the rib cage. Training occurred for 50 minutes a day and three days per week for four weeks. Results: FVC, MPT, peak expiratory flow, and rib cage width were increased and decreased at the VAS point for rolling after treatment. Conclusion: Patients with cervical spinal cord injuries who had breathing problems felt uncomfortable when they had conversations on a couch. We found that PNF direct and indirect treatments improved rib cage width and breathing functions of patients with cervical spinal cord injuries.

An Observational Study of Office Workers' Postural Behaviors During Computer Work (사무직 근로자의 컴퓨터 작업 자세의 관찰 연구)

  • Jun, Deok-Hoon;Goo, Mi-Ran
    • PNF and Movement
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    • v.19 no.2
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    • pp.243-250
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    • 2021
  • Purpose: The purpose of this study was to observe office workers' postural behaviors during computer work to identify the risk factors for head and thorax postural behaviors. Methods: The participants included 57 office workers who worked longer than 20 hours on a computer. Postural behaviors during computer work were measured using 3-D wearable motion sensors on the forehead and sternum. A multivariate linear regression model evaluated the association between various risk factors (neck pain, demographics, and environmental factors) and non-head and thorax postural behaviors. Results: The participants maintained their head and thorax in neutral postures (defined as 10° extension~10° flexion and 5° extension~10° flexion, respectively) for 24.7% and 39.3% of the total recorded time. Those who reported neck pain at the measurement of postural behaviors showed less time spent in thorax postures. Current neck pain, high desk height, and the distance between the keyboard and the edge of the desk (cm) were found to be related to less time spent in a neutral thorax posture. Conclusion: Office environment factors and current neck pain might affect workers' thorax postures, which might also determine the orientation of head postures during computer work.

The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam

  • Tran, Thiet Son;Pham, Thi Viet Dung;Ta, Thi Hong Thuy;Vu, Duy Kien;Nguyen, Thanh Liem
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.378-383
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    • 2021
  • Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30-70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients' skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

The first record of the winter stonefly genus Mesyatsia Ricker & Ross, 1975 (Plecoptera: Taeniopterygidae) from Korea

  • Hwang, Jeong Mi;Hur, Jun Mi;Kang, Ji Hyoun;Bae, Yeon Jae;Muranyi, David
    • Journal of Species Research
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    • v.10 no.4
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    • pp.419-421
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    • 2021
  • The genus Mesyatsia Ricker & Ross, 1975 is a small genus of the family Taeniopterygidae with only six species worldwide. This genus is mainly distributed in Asia, but has never been reported in Korea. In this paper, we report Mesyatsia makartchenkoi Teslenko & Zhiltzova, 1992 for the first time from the Korean Peninsula. The specimens were collected from Odaesan National Park, Bangtaesan Natural Recreation Forest, and Gariwangsan Natural Recreation Forest in Gangwon-do, South Korea by mainly Malaise traps and a few by sweep net. Some pharate larvae and adults crawling on the snow were also collected by handpicking. This species is characterized by the following features: pterostigma with dark spots; abdominal sternum 9 with vesicle; abdominal tergum 10 medially divided into two; subgenital plate strongly elongated, scoop-shaped, upcurved with tongue-shaped apex; cercus blunt. We provide materials, diagnosis for newly recorded species, and distributions. Additionally, we include a provisional key to the genera of Taeniopterygidae from Korea based on males.

A Study on the morphologic characteristics of each constitution's trunk (체간부의 사상체질별 형태학적 특징에 관한 연구)

  • Hong, Suck-chull;Lee, Su-kyung;Lee, Eui-joo;Han, Gi-hwan;Chou, Yong-jin;Choi, Chang-seok;Koh, Byung-hee;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.1
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    • pp.101-142
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    • 1998
  • 1. Objects The base of classification of Sasang Constitution was the different congenital formation of organs such as lungs, spleen, liver, kidneys, and it was expanded from the viscera region of lungs, spleen, liver, kidneys to the body shape of trunk. The researched about body shape of Sasang Constitution have had points of issues which derived by measurement with hands. But this study was measured the characteristics of body shape putting in importance of anatomical position with the computerized 3-Dimension scanner, which minimized the errors of measurement, and it was abled the cubic measurement such as volume, area of cross section as well as round length. 2. Materials & Method The examinee was healthy male 40 persons and female 20 persons from 20's to 40's, who was diagnosed by the specialist of Sasang Constitutional Medicine. The body shape was measured round length, area of cross section, and volume of 31 anatomical points and the 25 hypothesis with the Rapid 3D Color Scanner Model 3030 RGB/PS. And the characteristics of each constitution's body shape was derived. 3. Results & Concousion In female, Taeumin had the largest trunk and Soeumin had the smallest trunk compared to other constitution, but Soyangin had only the smallest neck. Soeumin has the smallest round length of nipple and the $CV_{12}$, and Soyangin has the smallest breadth of ASIS. Soyangin had the smallest volume from thyroid bone to the highest points of armpits and from sternum to nipple. Taeumin had the largest volume from sternum to the $CV_{12}$ and from sternum to xiphoid process. In male, Taeumin had the largest trunk and Soeumin had the smallest trunk from the level of thyroid bone to ASIS. Soyangin has the longest distance and Soeumin has the shortest distance from nipple to the lowest of breast. Taeumin had the largest volume of trunk and Soeumin had the smallest volume of trunk. In the ration of four-Cho, Taeumin had the longest distance from the highest points of armpits to nipple and Soyangin had the shortest distance of that. Soyangin had the smallest ratio of the height of upper middle cho. Soeumin had the smallest ratio from the $CV_{12}$ to navel among trunk. In the correlation among the four Cho, Taeumin had the negative correlation between the Upper-Cho and the Lower-Middle-Cho significantly.

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Implementation of a Falls Recognition System Using Acceleration and Angular Velocity Signals (가속도 및 각속도 신호를 이용한 낙상 인지 시스템 구현)

  • Park, Geun-Chul;Jeon, A-Young;Lee, Sang-Hoon;Son, Jung-Man;Kim, Myoung-Chul;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.22 no.1
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    • pp.54-64
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    • 2013
  • In this study, we developed a falling recognition system to transmit SMS data through CDMA communication using a three axises acceleration sensor and a two axises gyro sensor. 5 healthy men were selected into a control group, and the fall recognition system using the three axises acceleration sensor and the two axises gyro sensor was devised to conduct an experiment. The system was attached to the upper of their sternum. According to the experiment protocol, the experiment was carried out 3 times repeatedly divided into 3 specific protocols: falling during gait, falling in stopped state, and falling in everyday life. Data obtained in the falling recognition system and LabVIEW 8.5 were used to decide if falling corresponds to that regulated in an analysis program applying an algorithm proposed in this study. In addition, results from falling recognition were transmitted to designated cellular phone in a SMS (Shot Message Service) form. These research results show that an erroneous detection rate of falling reached 19% in applying an acceleration signal only; 6% in applying an angular velocity; and 2% in applying a proposed algorithm. Such finding suggests that an erroneous detection rate of falling is improved when the proposed algorithm is applied incorporated with acceleration and angular velocity. In this study therefore, we proposed that a falling recognition system implemented in this study can make a contribution to the recognition of falling of the aged or the disabled.

Discrimination of Fall and Fall-like ADL Using Tri-axial Accelerometer and Bi-axial Gyroscope

  • Park, Geun-Chul;Kim, Soo-Hong;Baik, Sung-Wan;Kim, Jae-Hyung;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.26 no.1
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    • pp.7-14
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    • 2017
  • A threshold-based fall recognition algorithm using a tri-axial accelerometer and a bi-axial gyroscope mounted on the skin above the upper sternum was proposed to recognize fall-like activities of daily living (ADL) events. The output signals from the tri-axial accelerometer and bi-axial gyroscope were obtained during eight falls and eleven ADL action sequences. The thresholds of signal vector magnitude (SVM_Acc), angular velocity (${\omega}_{res}$), and angular variation (${\theta}_{res}$) were calculated using MATLAB. When the measured values of SVM_Acc, ${\omega}_{res}$, and ${\theta}_{res}$ were compared to the threshold values (TH1, TH2, and TH3), fall-like ADL events could be distinguished from a fall. When SVM_Acc was larger than 2.5 g (TH1), ${\omega}_{res}$ was larger than 1.75 rad/s (TH2), and ${\theta}_{res}$ was larger than 0.385 rad (TH3), eight falls and eleven ADL action sequences were recognized as falls. When at least one of these three conditions was not satisfied, the action sequences were recognized as ADL. Fall-like ADL events such as jogging and jumping up (or down) have posed a problem in distinguishing ADL events from an actual fall. When the measured values of SVM_Acc, ${\omega}_{res}$, and ${\theta}_{res}$ were applied to the sequential processing algorithm proposed in this study, the sensitivity was determined to be 100% for the eight fall action sequences and the specificity was determined to be 100% for the eleven ADL action sequences.

Two Cases of Cartilagenous Tumor in the Head & Neck (두경부 영역에서 연골성 종양 치험례)

  • Lee Hwan-Koo;Choi Yong-Seung;Tae Kyung;Lee Hyung-Seok;Kim Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.63-73
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    • 1994
  • Chondrosarcomas are uncommon disease that are noted almostly in the pelvis, sternum, long bone. Chondrosarcoma in the head & neck was very rare. It can occur in nearly every bone in the head and neck. Lesion of the maxilla is most frequent site in head and neck region, but temporomandibular joint is rare site. In chondrosarcoma of temporomandibular joint, its danger lies in its local invasiveness and potential to seed into the meninges. Histologically, the tumor exhibits myxoid feature, which must be differentiated from chordoma and chondroid chordoma. The cranial nerve palsies frequently observed with the tumors are related to the anatomical location. Chondroma is a benign tumor that most frequently found in the hand, foot bone, but can be originated in any cartilagenous area of body. When it occurs in one site, it is named as solitary enchondroma, and when it occurs in multiple site, it is named as multiple enchondromatosis. In the head & neck, it may occur in the nasal cavity, nasopharynx, nasal septum, eustachian tube, palate. But chondroma that occur as neck mass is extremely rare. Recently, the authors experienced a case of chondrosarcoma confirmed pathology affecting 35-years-old female presenting mass in left temporomadibular joint and a case of chondroma confirmed pathology affecting 26-years-old female presenting neck mass, left.

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Improved Nipple Location in Young Korean Patients

  • Lee, Bo Hyung;Kwon, Yu Jin;Park, Jang Wan;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.748-752
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    • 2014
  • Background Gynecomastia is benign enlargement of breast tissue in males and is fairly common. Mastectomy not only helps in improving the shape of anterior chest, but can also improve the location of nipple. Therefore, a principle element of mastectomy design is defining the normal location of nipple based on major anatomical reference points. Here, the nipple location was compared for before and after gynecomastia surgery. In addition, the same was also compared between male patients undergoing gynecomastia surgery and control group of subjects without gynecomastia. Methods We retrospectively analyzed gynecomastia patients who underwent conventional subcutaneous mastectomy. Preoperative and postoperative anatomical landmark distances and chest circumferences were measured and compared to the same anthropometric data from 20 healthy adult male controls. Results Nipple locations were compared among 13 patients and 20 controls. The mean weight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 out of 5. In the patient group, the slopes for the height-distance from the sternal notch to the nipple and chest circumference-distance between the mid-line of the sternum and the nipple were 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122 and 0.177, respectively; these differences were statistically significant (P<0.05). Conclusions Nipple positions were considerably lower in patients with gynecomastia than in control subjects. Subcutaneous mastectomy was associated with mild elevations, but postoperative locations were still lower compared to controls. Further efforts are needed to improve the location of postoperative nipple-areola complex in patients with gynecomastia.