Nontyphoidal Salmonella are gram negative bacilli organism, which may induce systemic infection such as febrile enteritis, bacteremia, and osteomyelitis. Main route of infection is known as food but also possible through reptile, amphibian, and fish raised as pets in the house. There is no known cases report of Salmonella infection through pets in Korea and also rare in the overseas. We report 2 patients who visited Severance children's hospital with chief complaint of fever and diagnosed as nontyphoidal salmonellosis. Each case had a history of raising turtle or tropical fish with possibility of Salmonella infection through these pets. Increasing incidence of raising pet reptile and fish lately, contact precaution and proper prevention and control of Salmonella infection of these pets especially in children under 5 years old are necessary due to higher risk of serious complications of salmonellosis.
Amphibians ; Bacteremia ; Child ; Enteritis ; Fever ; Fishes ; Humans ; Incidence ; Korea ; Osteomyelitis ; Reptiles ; Salmonella ; Salmonella Infections ; Turtles

Traditional adipose tissue transplantation has unpredictable viability and poor absorption rates. Recent studies have reported that treatment with platelet-rich plasma (PRP), adipose-derived stem cells (ASCs), and stromal vascular fraction (SVF) are related to increased survival of grafted adipose tissue. This study was the first simultaneous comparison of graft survival in combination with PRP, ASCs, and SVF. Adipose tissues were mixed with each other, injected subcutaneously into the back of nude mice, and evaluated at 4, 8, and 12 weeks. Human adipocytes were grossly maintained in the ASCs and SVF mixtures. Survival of the adipose tissues with PRP was observed at 4 weeks and with SVF at 8 and 12 weeks. At 12 weeks, volume reduction in the ASCs and SVF mixtures were 36.9% and 32.1%, respectively, which were significantly different from that of the control group without adjuvant treatment, 51.0%. Neovascular structures were rarely observed in any of the groups. Our results suggest that the technique of adding ASCs or SVF to transplanted adipose tissue might be more effective than the conventional grafting method. An autologous adipose tissue graft in combination with ASCs or SVF may potentially contribute to stabilization of engraftment.
Adipocytes/*transplantation ; Adipose Tissue/cytology/*transplantation ; Adult ; Animals ; Female ; *Graft Survival ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; *Platelet-Rich Plasma ; Stem Cells ; Stromal Cells/*transplantation ; Transplantation, Heterologous

PURPOSE: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. MATERIALS AND METHODS: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. RESULTS: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. CONCLUSION: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.
Angiography* ; Arteries* ; Fascia ; Perforator Flap* ; Skin ; Subcutaneous Tissue ; Transplants ; Ulcer* ; Wound Closure Techniques

Objectives: This study aimed to assess the feasibility of implementing OpenNotes in Korea. It involved developing and evaluating the Open-CHA service, which provides clinical summary information to patients diagnosed with craniofacial deformities and their caregivers following outpatient visits. Methods: The study included 109 patients diagnosed with craniofacial deformities, along with their caregivers. The Open-CHA service was developed by referencing OpenNotes and involved a user needs assessment, a pilot test, and an evaluation of its effectiveness. Data were analyzed using descriptive statistics and the paired t-test. Results: Short message service templates for the Open-CHA service based on a user needs assessment conducted with patients, caregivers, and healthcare professionals. These templates were refined and improved following a pilot test. After the implementation of the Open-CHA service, most participants evaluated OpenNotes positively. Additionally, there were observed increases in health knowledge and efficacy in patient-physician interactions. A statistically significant improvement in mobile health literacy was also confirmed. Conclusions The implementation of the Open-CHA service significantly enhanced mobile health literacy among patients with craniofacial deformities and their caregivers, indicating positive outcomes for the potential adoption of OpenNotes in Korea. This suggests that introducing OpenNotes into the Korean healthcare system is appropriate.

Objectives: This study aimed to assess the feasibility of implementing OpenNotes in Korea. It involved developing and evaluating the Open-CHA service, which provides clinical summary information to patients diagnosed with craniofacial deformities and their caregivers following outpatient visits. Methods: The study included 109 patients diagnosed with craniofacial deformities, along with their caregivers. The Open-CHA service was developed by referencing OpenNotes and involved a user needs assessment, a pilot test, and an evaluation of its effectiveness. Data were analyzed using descriptive statistics and the paired t-test. Results: Short message service templates for the Open-CHA service based on a user needs assessment conducted with patients, caregivers, and healthcare professionals. These templates were refined and improved following a pilot test. After the implementation of the Open-CHA service, most participants evaluated OpenNotes positively. Additionally, there were observed increases in health knowledge and efficacy in patient-physician interactions. A statistically significant improvement in mobile health literacy was also confirmed. Conclusions The implementation of the Open-CHA service significantly enhanced mobile health literacy among patients with craniofacial deformities and their caregivers, indicating positive outcomes for the potential adoption of OpenNotes in Korea. This suggests that introducing OpenNotes into the Korean healthcare system is appropriate.

Objectives: This study aimed to assess the feasibility of implementing OpenNotes in Korea. It involved developing and evaluating the Open-CHA service, which provides clinical summary information to patients diagnosed with craniofacial deformities and their caregivers following outpatient visits. Methods: The study included 109 patients diagnosed with craniofacial deformities, along with their caregivers. The Open-CHA service was developed by referencing OpenNotes and involved a user needs assessment, a pilot test, and an evaluation of its effectiveness. Data were analyzed using descriptive statistics and the paired t-test. Results: Short message service templates for the Open-CHA service based on a user needs assessment conducted with patients, caregivers, and healthcare professionals. These templates were refined and improved following a pilot test. After the implementation of the Open-CHA service, most participants evaluated OpenNotes positively. Additionally, there were observed increases in health knowledge and efficacy in patient-physician interactions. A statistically significant improvement in mobile health literacy was also confirmed. Conclusions The implementation of the Open-CHA service significantly enhanced mobile health literacy among patients with craniofacial deformities and their caregivers, indicating positive outcomes for the potential adoption of OpenNotes in Korea. This suggests that introducing OpenNotes into the Korean healthcare system is appropriate.

Objectives: This study aimed to assess the feasibility of implementing OpenNotes in Korea. It involved developing and evaluating the Open-CHA service, which provides clinical summary information to patients diagnosed with craniofacial deformities and their caregivers following outpatient visits. Methods: The study included 109 patients diagnosed with craniofacial deformities, along with their caregivers. The Open-CHA service was developed by referencing OpenNotes and involved a user needs assessment, a pilot test, and an evaluation of its effectiveness. Data were analyzed using descriptive statistics and the paired t-test. Results: Short message service templates for the Open-CHA service based on a user needs assessment conducted with patients, caregivers, and healthcare professionals. These templates were refined and improved following a pilot test. After the implementation of the Open-CHA service, most participants evaluated OpenNotes positively. Additionally, there were observed increases in health knowledge and efficacy in patient-physician interactions. A statistically significant improvement in mobile health literacy was also confirmed. Conclusions The implementation of the Open-CHA service significantly enhanced mobile health literacy among patients with craniofacial deformities and their caregivers, indicating positive outcomes for the potential adoption of OpenNotes in Korea. This suggests that introducing OpenNotes into the Korean healthcare system is appropriate.

Anesthesia, General ; Anesthesia, Inhalation ; Busan ; Female ; Granuloma ; Hoarseness ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Laryngeal Mucosa ; Larynx ; Male ; Orthognathic Surgery ; Retrospective Studies ; Surgery, Oral

PURPOSE: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. METHODS: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, follow-up period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. RESULTS: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were 17.0 +/- 13.99%, 25.0 +/- 12.70%, 30.0 +/- 12.57% and 30.8 +/- 12.49% at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. CONCLUSION: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.
Breast ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Nipples ; Rectus Abdominis ; Retrospective Studies ; Skin ; Tattooing ; Transplants

PURPOSE: Since the hand elevation test was first introduced by Ahn in 2001, it has been one of most performing provocative test for diagnosing carpal tunnel syndrome. Although many studies have been published on the hand elevation test, there are no study that can explain why false-negative results of hand elevation test appears in carpal tunnel syndrome patients diagnosed by electromyography (EMG) findings. Therefore we searched out whether hand elevation test is related with EMG severity. MATERIALS AND METHODS: We made a retrospective study of 654 bilateral carpal tunnel syndrome patients. Among them 134 were studied which had different hand elevation test results on each hands. The paired samples t-test was used to compare the EMG severity of each group. The relationships between hand elevation test and EMG severity were examined using Pearson-product correlations. Comparing whether the frequency of false negative hand elevation were different between both hands, and whether the severity of EMG depends on which side of hand is, was evaluated with Mann-Whitney U-test. RESULTS: Severity of EMG in positive group was moderate to severe on average, whereas mild to moderate on negative group, with significant difference statistically (p<0.001). Correlation between the hand elevation test results and EMG severity also showed significance statistically (p<0.001). CONCLUSION: Mild severity of EMG was found out to be the factor affecting the false results. However, EMG severity and hand elevation test shows a meaningful correlation, supporting the value of hand elevation test.
Carpal Tunnel Syndrome* ; Electromyography* ; Hand* ; Humans ; Retrospective Studies