The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*

Though proper management of hand burns in children is provided, hypertrophic scars frequently cause various hand deformities or functional disturbances in growing hands. When correction principles have not been observed for the long term, contraction of the skin, tendon and joints has a serious influence on hand deformities and bone change occur in growing children and second, to determine when is the proper operative time to minimize hand deformities and recurrences. We reviewed 107 hands in 103 admitted pediatric patients who had postburn hands deformities by scar contracture. The analysis of severity of hand deformities was evaluated by assessment of our hospital scale. According to these data, we performed the operations and compared the final results. The results were as follows: The types of burn hand deformities among 107 involved hands of 103 patients included flexion contracture (39.3%), syndactyly (29.9%), extension contracture (10.3%), Boutonniere deformity (9.3%), claw hand deformity (5.6%), severe hypertrophic scar (3.7%), swan neck deformity (0.9%), and loss of digit (1.9%) etc. On 98 preoperative x-ray examinations, bone changes were common, including angular deformity (19.4%), epiphyseal plate loss(18.4%), osteoporosis (17.3%), bony erosion (17.3%), joint change (15.3%), and ankylosis (9.2%). Thus, early correction of postburn hand deformities is imperative in pediatric patients, even though there is a greater chance of secondary operation due to immature scars. All patients were operated on by our proposed protocol and postoperative results showed greatly improved finger joint motion than before. We concluded that early correction of Grade III to V postburn hand deformities is mandatory in rapidly growing pediatric patients.
Animals ; Ankylosis ; Burns* ; Child* ; Cicatrix* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Finger Joint ; Growth Plate ; Hand Deformities* ; Hand* ; Hoof and Claw ; Humans ; Joints ; Neck ; Operative Time ; Osteoporosis ; Recurrence ; Skin ; Syndactyly ; Tendons

PURPOSE: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. METHODS: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. RESULTS: The hematologic indicators (WBC and Hemoglobin) were significant for explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. CONCLUSIONS: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.
Activities of Daily Living ; Adaptation, Physiological ; Adult ; Aged ; Fatigue/etiology/*nursing ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Models, Nursing ; Multivariate Analysis ; Neoplasms/complications/*nursing ; Sick Role ; Sickness Impact Profile

PURPOSE: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. METHODS: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's α. RESULTS: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's α of the total items was .83 and the factors ranged from .44 to .75. CONCLUSION: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.
Breast Feeding* ; Humans ; Milk ; Mothers ; Postpartum Period ; Weights and Measures

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

PURPOSE: This study was done to examine the association between body mass index (BMI) and any type of clinical dementia. METHODS: Participants were 60,321 people over 60 years of age enrolled in the Seoul Dementia Management Project in 2011. K-MMSE was used to classify participants as having a cognitive impairment and the Clinical Dementia Rating or DSM-IV by psychiatrists or neurologists to determine whether participants were in the dementia group or the non-dementia group. Descriptive statistics, chi-square test, and binary logistic regression analysis were performed. RESULTS: In the univariate analysis, age, education level, living with spouse, BMI, alcohol consumption, and exercise were significantly associated with dementia. In multivariable analysis, increasing age was positively associated with dementia, and educational level was negatively associated with dementia. The exercise group had a lower prevalence of dementia than the non-exercise group. The odds ratio of dementia in the over-weight and obese groups compared to the normal group was 0.85 (95% CI 0.60, 0.98) and 0.64 (95%CI 0.46, 0.75), respectively. CONCLUSION: Results indicate that dementia is negatively associated with increasing BMI in people aged 60 years or older, but a prospective cohort study is needed to elucidate the causal effect relationship between BMI and dementia.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Mass Index ; Cross-Sectional Studies ; Dementia/*epidemiology ; Exercise ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Residence Characteristics ; Risk Factors ; Smoking

PURPOSE: The study was done to construct and test a structural model to explain primipara breastfeeding behavior. METHODS: The participants were 213 primiparas on postpartum wards. Data were analyzed using the PASW 18.0 and AMOS 19.0 programs. RESULTS: Fitness statistics for the hypothetical model were appropriate (chi2 =38.50, p=.070, GFI=.96, RMSEA=.05, AGFI=.93, NFI=.95, TLI=.97, CFI=.98, PNFI=.57, chi2/df=1.43). Breastfeeding behaviors were directly influenced by intention to breastfeed, perceived effectiveness of breastfeeding, and the amount of supplementary feeding. The amount of supplementary feeding had the largest direct impact on breastfeeding behavior. The largest total effect on breastfeeding behavior was intention to breastfeed. The environment of the maternity hospital indirectly influenced breastfeeding behavior. These factors explained 18.9% of variance in the primipara breastfeeding behavior. CONCLUSION: The results of the study indicate that in order to promote primipara breastfeeding the amount of supplementary feeding immediately after the birth should be limited and an environment that encourages exclusive breastfeeding in the hospital should be provided. The results also suggest it is necessary to provide nursing interventions that increase the intention to breastfeed and the perceived effectiveness of breastfeeding.
Adult ; Bottle Feeding ; Breast Feeding/*statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Intention ; *Models, Structural ; Mothers/psychology ; Questionnaires ; Young Adult

BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

We have reviewed ovarian mature cystic teratomas with features of chronic thyroiditis that were diagnosed at the department of pathology, Seoul National University Hospital during 7 years, 1984-1991. Twenty three case(8%) containing thyroid tissue among 285 ovarian mature teratomas were available for histopathologic examination. Among these, 4 cases(1.4%) showed lymphocytic infiltration with lymphoid follicle formation. These four cases were examined according to the strict histologic criteria of autoimmune thyroiditis and reactive non-autoimmune thyroiditis for the purpose of differentiation of pathogenesis. Two cases were similar to autoimmune in nature and the other two cases simply seemed to reflect reactive features to adjacent stimulating elements. In conclusion, thyroid tissue present in ovarian cystic teratoma may have histologic features of chronic thyroiditis of either autoimmune or non-autoimmune origin.