Purpose: The hand and forearm are the common points of contact and entry for electrical burns. Wounds from electrical burns can range from small to large and superficial to deep. High-voltage electrical burns result in skin and/or soft-tissue defects owing to progressive necrosis caused by intravascular thrombosis, causing complications in the coverage of electrical burns.Various coverage methods have been used for electrical burns on the hands and forearms. Methods: Between 2017 and 2022, 61 patients were admitted for electrical burn treatment on the forearm and hand in our department; and 41 underwent coverage surgery. The range of motion was evaluated when feasible pre-and post-operatively. Results: Among the 41 patients who underwent coverage surgery, 16 and 25 suffered deep second-and third-degree burns, respectively. Wounds of the remaining 20 healed with wound dressings as they were superficial or small. Patients with deep second-degree burns required various procedures, including full-thickness skin graft (FTSG), advanced local flap, split-thickness skin graft (STSG), and STSG with acellular dermal matrix (ADM). Procedures for patients with third-degree burns include an advanced local flap, STSG with ADM, FTSG, and other flap surgeries. All the wounds healed without major complications. Conclusion We successfully treated 41 burn wounds using different wound coverage methods, such as STSG or STSG with ADM for deep second-degree burns and flap surgery for third-degree burns. Moreover, in third-degree burns, STSG with ADM could substitute for flap surgery if flap surgery is not performed.

A common goal in reconstructing the umbilicus is to achieve an aesthetically pleasing result. This single-subject study demonstrates the outcome of managing an umbilical keloid scar using a single excisional line. A patient presented with a large, oval keloid scar at the center of his abdomen. The scar, measuring 4×3 cm in diameter, was deformed to the extent that it completely obscured the umbilicus. The patient frequently experienced intermittent inflammation at the site of the scar. We planned a triangular incision around the keloid. The umbilical keloid was excised and reconstructed using a flap anchored along the lower edge of the triangle. The triangular flap was elevated and the deep dermis of its cephalic portion was attached to the linea alba. The remainder of the flap was sutured at the center to create a conical shape. Eleven months post-procedure, the umbilicus maintained an aesthetically pleasing appearance with proper depth, superior hooding, and a concave shape without protrusion. An advantage of this straightforward surgical method is that it allows for simultaneous resection and reconstruction without the need for additional flap design. This method is expected to be a useful option for reconstructing umbilical keloids the size of a fully developed umbilicus.

OBJECTIVE: The objective of this study is to compare the effectiveness and safety in the labor induction between the high dose oxytocin method and the new low dose oxytocin method. STUDY DESIGN: Firstly, we selected 125 pregnant women hospitalized, having the indication of labor induction from March, 1995 to August, 1996. Of them, we selected 61 pregnant women tothem the high dose oxytocin method was used, as the control group, and in- creased the quantity of 2.5 mU/min every 20 minutes with the start dose of 2.5 mU/min to them. On the other hand, with the start dose of 1.25 mU/min, we increased the quantity of 1.25 mU/min every 20 minutes to the study group of low dose oxytocin method, 64 pregnant women. RESULTS: No statistical significance was found in the time from the effective uterine contraction to the delivery in the study group, in contrast to that of the control group to them the labor induction was conducted by using the high dose oxytocin. Maximum amount used to the high dose oxytocin was significantly more than that of the low dose oxytacin, but in the total given dose, there was no significant difference between two groups. Maxi- mum uterine contraction of the control group did not show any significant. difference from that of the study group, and there was also no significant difference in the frequency of generating the complications such as fetal distress. CONCLUSION: There was no difference in the labor.induction -to delivery time, and the complications of fetus, between the existing high dose oxytocin method and the new low dose oxytocin method. Therefore it is thought the low dose oxytocin method may reduce the possibility of a complieation compared with the high dose oxytocin method. However, it is considered this matter must be investigated further in the futrre.
Female ; Fetal Distress ; Fetus ; Hand ; Humans ; Oxytocin* ; Pregnant Women ; Uterine Contraction

Purpose: Elderly people are particularly susceptible to burn injuries due to physiological and anatomical aging processes. As the elderly population is expected to grow, the number of burn injuries among this group is also likely to increase. Researchers and health professionals must analyze the causes of geriatric burn injuries, establish targeted preventive policies, and provide education on strategies to minimize burns. Methods: To understand the epidemiological causes of burns in the elderly, we retrospectively reviewed the medical records of patients admitted to our burn center in Korea between January 2019 and December 2021. Of 1,082 patients admitted with burn injuries, 323 (29.9%) were aged 65 years or older and were included in further examination. Results: The elderly patients included more women (64.1%) than men (35.9%), and the causes of burns differed according to gender. Flame burns were more common among men than women, and only men experienced electrical burns. Most older people live alone (54%); accordingly, the most common place of injury for these patients was home (77%), followed by the workplace (14%), with the causes of burns differing between those locations. Sixteen patients (4.9%) started medical treatment at least 2 weeks post-injury, while 29 patients (8.9%) began burn treatment after 1 month. Scalding (55.4%) was the most common cause of burn injury. Most injuries were deep second-(35%) or third-(39%) degree burns, and the most common treatment method was surgery (64.7%). The most frequently affected areas were the legs (24%) and feet (23%). Conclusion Through this analysis of the clinical profile of burns in the elderly, we endeavored to help establish suitable preventive policies.

Deep electrical burn on the hand and forearm causes ischemic tissue damage due to increased compartment pressure by tight eschars. Early detection of ischemia and prompt release of eschars are necessary for prevention of ischemic tissue damage. Early escharotomy is a useful decompressive therapy for prevention of ischemia of the distal upper extremity.

Purpose: Firefighting duties range from field roles such as suppression, rescue, and emergency medical services (EMS) to various administrative tasks. Despite these differences, they face uniform fitness standards in Korea. This study seeks to define distinct fitness needs for each duty and provide data for customized standards. Methods: One hundred seventy-six Korean male firefighters participated, categorized into suppression (n=76), rescue (n=22), administrative (n=27), and EMS (n=51) roles. All underwent maximal oxygen consumption (VO2 max) tests for aerobic capacity, with body composition measured using bioelectrical impedance and height recorded with a stadiometer. Results: The VO2 max (mL/kg/min) among Korean male firefighters varied across different job duties: suppression (39.96±5.84), rescue (44.84±4.85), administration (40.27±7.01), and EMS (40.51±6.75). Rescue had the highest VO2 max, which was significantly higher (p=0.013). The body mass index (BMI, kg/m2 ) values were as follows: suppression (25.07±2.55), rescue (24.95±1.71), EMS (24.33±3.21), and administration (25.10±2.48). There was no statistically significant difference in BMI values (p=0.464). Conclusion This study evaluated the VO2 max and BMI of South Korean male firefighters according to their job duties. It found that 54.5% did not meet the recommended VO2 max standard of 42 mL/kg/min for their activities, and 77.5% had a BMI indicating overweight or higher. However, it is important to note that not every firefighting duty requires high fitness levels. The key is ensuring firefighters possess the fitness necessary for their specific roles to maintain safety and efficiency. The study aims to provide data for creating fitness management guidelines tailored to the diverse duties of firefighters.

No abstract available.
Head Injuries, Penetrating*

In order to define the prognostic implications of cervical myelopathy, we conducted a morphometrical analysis of spinal cords in patients suffering from this condition. Twenty patients who had undergone laminoplasty for their cervical myelopathy were the subject of this study. Cervical spondylosis was diagnosed in 14 patients and ossification of the posterior longitudinal ligament in six. Signal change of the spinal cord, its anteroposterior diameter, and the number of stenotic segments were determined by pre- and postoperative magnetic resonance imaging and simple X-ray. The patients' neurological status before and after surgery was evaluated by the Neurosurgical Cervical Scale. Patients whose cord revealed no signal change had better recovery rates than those who showed change (77.5% vs. 60.5%). The wider the diameter of the cord, the better the outcome of surgery(p<0.05 on one-way ANOVA). The number of stenotic segments was not significantly related to recovery rate. In conclusion, focal morphological changes of the spinal cord, regardless of the general stenotic area, are the main factors determining the outcomes of surgery.
Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Spinal Cord ; Spinal Cord Diseases* ; Spondylosis

OBJECTIVE:To evaluate the normal figure of intracranial and intraspinal cerebrospinal fluid(CSF) dynamics, we report the results of the various parameters of cine phase contrast(PC) magnetic resonance(MR) CSF flow images throughout the whole neuraxis. METHODS: The MR images were obtained with 1.5T unit using the cine PC sequence with cardiac gating and gradient echo imaging in 10 normal persons(mean age, 30.4 years). The temporal velocity information from the anterior and posterior cervical pericord subarachnoid spaces, third and fourth ventricles, aqueduct, and lumbar cistern were plotted as wave forms. The wave forms were analyzed for configurations, amplitude parameters, and temporal parameters. The statistical significance of each parameter was examined with paired t-test. RESULTS: The actual flow of CSF were clearly visible with cine MR images. Throughout the whole neuraxis, the distinct reproducible configuration features were not obtained at ventricular or lumbar cistern, but at aqueduct and cervical pericord spaces. The temporal parameters were more important than the amplitude parameters. CONCLUSION: In this study, the authors demonstrated normal CSF dynamics and obtained further precision by plotting the temporal velocity information from the images as a waveform. This important basic information may be useful for understanding altered physiology in disease states such as syringomyelia and hydrocephalus.
Cerebrospinal Fluid* ; Fourth Ventricle ; Hydrocephalus ; Magnetic Resonance Imaging ; Physiology ; Subarachnoid Space ; Syringomyelia

No abstract available.
Arteriovenous Malformations* ; Hematoma*