From March 1983, 20 patients had undergone reconstruction of the upper limb with 22 vascularized composite tissue grafts. The microsurgical procedures had several advantages for reconstruction of injured upper limbs as follows: 1. Free tissue transfer was quite an important and attractive procedure for reconstruction of an injured limb, expecially an upper limb. 2. Free vascularized transfer of composite tissue with its overlying skin was a reliable technique to obtain full thickness soft tissue coverage of a severely injured upper limb when more conservative procedures, such as the use of skin graft or local muscle flaps, had failed or were not feasible. 3. A simple skin flap could be transfered to close an open wound of the limb, but a sensory flap or a special flap such as a nail-skin, tendon-skin or muscle-skin flap was a much better donor for reconstructing the function of the upper limb. 4. When appropriate, the wrap-around procedure was the method of choice for thumb reconstruction because the great toe was preserved. The procedure provided length, stability and adequate sensibility for a functional pinch and grasp. 5. The cosmetic effect of a second-toe transplant might be inferior to the wrap-around flap, but it had the great advantage of being able to provide mobile joints in the reconstructed thumb. As far as the donor foot was concerned, no patients had real trouble functional impairment.
Extremities ; Foot ; Hand Strength ; Humans ; Joints ; Methods ; Microsurgery ; Skin ; Thumb ; Tissue Donors ; Toes ; Transplants ; Upper Extremity ; Wounds and Injuries

PURPOSE: Periventricular leukomalacia(PVL) is associated with the characteristic neurologic sequale of spastic diplegia or quadriplegia, and cortical blindness. So early diagnosis of PVL in the neonatal period is of importance because of the prognostic implications of this lesion. Novotny et al reported that Positive Rolandic Sharp waves(PRS) on the EEGs was a marker of PVL because most infants who had excessive PRS on their EEGs also had PVL on their neurosonography. PRS were present in most neonates at a time when neurosonography showed periventricular echodense lesions, prior to the appearance of cystic PVL. Therefore, the appearance of excessive PRS on the EEG is very useful for the early detection of PVL. The aim of this study is to assess the relationship between the PVL and PRS on the EEGs, to observe the appearance timing of PRS on the EEGs, and to evaluate the risk factors of later neurologic sequale. METHODS: Among the neonates admitted to the Sowha Childern's Hospital between 1989 and June 1993, 25 neonates with cystic PVL on neurosonography or CTscan were the study group. Control group were the age-matched 20 neonates who were admitted at the same time of study period. We reviewed the neurosonographic findings, EEG features, and charts retrospectively. RESULTS: 1) Excessive PRS were observed in 20 cases of study group(80%), whereas 1 case in control group(5%)(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The frequency of PRS in a 10 minutes epoch was 14.5+11.1 in the study group, whereas 1.57+1.96 in the control group(p<0.001). 4) In most neonates, PRS were present at a time when the neurosonography showed periventricular echodense lesion or cystic PVL. 5) In a follow-up neurosonography, 12 among 17 neonates with localized PVL were normalized and only 5 cases had ventriculomegaly. Whereas, all of 5 extensive PVL had the sequale of ventriculomegaly or cerebral atrophy. 6) In a follow-up neurologic examination, the poorer sequale including spastic diplegia or quadriplegia was associated with the larger, the more extensive, and the subcortical PVL. CONCLUSIONS: 1) Excessive PRS were significantly more observed in the study group than in the control group(p<0.001). 2) The frequency of PRS was not affected by the abnormality of EEG background activity. 3) The prognosis of the neonates with PVL was depended on the size, extent, and location of the PVL rather than the presence or frequency of PRS.
Atrophy ; Blindness, Cortical ; Cerebral Palsy ; Early Diagnosis ; Electroencephalography ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Leukomalacia, Periventricular* ; Neurologic Examination ; Prognosis ; Quadriplegia ; Retrospective Studies ; Risk Factors

No abstract available.
Genetic Loci* ; Loss of Heterozygosity* ; Stomach Neoplasms*

No abstract available.
Immunoglobulins* ; Tuberculosis, Pulmonary*

This study conducted to assess the effectiveness of nutrition education program for elderly females with various diseases. Forty subjects(hypertension ; 20, diabetes ; 12, hyperlipidemia ; 8) out of 56 completed the 7 weeks nutrition education program. The nutrition education program was based for healthy food habits and dietary guidelines for each specific disease. It also included practicing individualized menu planning and exercising program. Energy, calcium, iron, vitamin A and ash intakes significantly increased in the hypertension group. total sodium intake did not decrease, however sodium intake per kcal decreased significantly(p<0.05). Elderly with diabetes did not show any changes in dietary intakes. Dietary protein, plant fat, ash, and sodium intakes were significantly elevated(p<0.05), but cholesterol intakes significantly decreased(p<0.05) in the hyperlipidemic group. Elderly with hypertension agreed strongly with changes of food habits such as increasing milk intake, and decreasing Kimchi, soup, pickles and salty food, and table salt intakes after nutrition education. Diabetic elderly showed significantly improved food habit scores in decreasing white rice intake, sugar intake and increasing sea-weed consumption, vegetable consumption and exercise. Hyperlipidemic elderly did not show much improvement in food habit scores except in biochemical indices. However, mean serum glucose and atherogenic index decreased in the diabetic and hyperlipidemic groups after education, respectively.
Aged* ; Blood Glucose ; Calcium ; Cholesterol ; Chronic Disease* ; Dietary Proteins ; Education* ; Female ; Food Habits ; Humans ; Hyperlipidemias ; Hypertension ; Iron ; Menu Planning ; Milk ; Nutrition Policy ; Plants ; Public Health* ; Sodium ; Sodium Chloride, Dietary ; Vegetables ; Vitamin A

This study was performed to assess the nutritional status, frequency of visiting and necessity of nutrition programs for 157 elderly(male:49, female:108) visiting public health centers in Puchon. The purpose of the study was to provide the basic data for developing a nutrition service model. The subject were investigated by interviews with a questionnaire to obtain dietary data and other information related to public health center. Blood tests for analyzing biochemical status were also carried out. The elderly showed low income status. Ninety two percent of them showed their monthly income was less than 400,000 won and 72.6% was observed as having 30,000 won/month as their pocket money. The most frequent disease reported as having or being treated were hypertension(32.6%), rheumatic arthritis(28.5%), diabetes(10.2%), and stomach disease(8.2%) for males and hypertension(33.1%), diabetes(19.4%), rheumatic arthritis(16.7%), anemia(11.1%) for females. The nutrients whose daily intakes were less than 2/3 of RDA were calcium(37.5% RDA),vitamin A(49.9% RDA), iron(60.0% of RDA) and protein(62.0% RDA) for males and vitamin A(27.7% RDA), vitamin B2 (33.3% RDA), calcium(44.1% RDA), iron(53.3% RDA), and niacin(60.0% RDA) for females, respectively. Prevalence of anemia, assessed by hemogloben using WHO definition, were 4.1% for males and 18.5% for females. The percentage of males with hypercholesterolemia( 220 mg/dl) was 2.1% and 19.4% fir females, Two percent of males and 12.0% of females were observed as having a LDL-C higher than 165 mg/dl. The mean fasting blood glucose(FBG) level of males and female was 84.2 mg/dl and 101.7 mg/dl respectively. Two percent of males and 8.3% of females were found with a FBG higher than 140 mg/dl. Seventy one percent of elderly reported they were visiting public health centers at least once per week or more frequently. They were satisfied most with the low medical bills but showed the lowest satisfaction for the facilities of the public health centers. What the nutrition service programs wanted most was nutrition counseling and guidance.
Aged* ; Anemia ; Counseling ; Fasting ; Female ; Gyeonggi-do ; Hematologic Tests ; Humans ; Male ; Nutritional Status* ; Prevalence ; Public Health* ; Riboflavin ; Stomach ; Vitamins ; Surveys and Questionnaires

We present a case of transient acantholytic dermatosis which developed on the face of a 19-year-old Korean girl. Asyrnptomatic pinhead to miliary-grain sized brownish papules arranged in a somewhat band-like outbreak along the left side of the nose for about 3 months. Histopathologic findings were similar to Dariers disease. Immunoperoxidase staining showed that IgG was deposited on the intercellular area of keratinocytes around the suprabasal clefts. Skin lesions disappeared spontaneously in 5 weeks after a skin biopsy.
Biopsy ; Darier Disease ; Female ; Humans ; Immunoglobulin G ; Keratinocytes ; Nose ; Skin ; Skin Diseases* ; Young Adult

Menkes disease is an X-linked recessively inherited neurodegenerative disorder of copper metabolism leading to death in early childhood. This disease is characterized by low serum, liver and brain Cu levels, whereas the Cu content in nearly all other organs is increased. The main clinical features are irregular kinky hair, characteristic face, progresssive degeneration of the central nervous system, bone changes, arterial rupture and thrombosis, and instability of temperature. We have experienced a case of Menkes disease in a eight months old male patient, who manifested by seizure, developmental delay, hypotonia, characteristic hair and face along with low levels of serum copper and ceruloplasmin. We report the characteristic findings of cranial MRI and MR angiography in this Menke's patient. In cranial MRI, he showed progressive brain atrophy with subdural hemorrhage and effusion. MR angiography revealed tortuosity of vessels clearly obviating necessity of more invasive conventional arteriography in diagnosis of this disease. This study suggested that cranial MRI and especially MR angiography might be helpful in making early diagnosis of this disease.
Angiography ; Atrophy ; Brain ; Central Nervous System ; Ceruloplasmin ; Copper ; Diagnosis ; Early Diagnosis ; Hair ; Hematoma, Subdural ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Menkes Kinky Hair Syndrome ; Metabolism ; Muscle Hypotonia ; Neurodegenerative Diseases ; Rupture ; Seizures ; Thrombosis

The purpose of this study was to investigate factors associated with Bone Mineral Density (BMD) in Korean postmenopausal women. The data from 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects were 2,701 postmenopausal women aged > or = 50 years. BMDs at whole body, total femur, femoral neck, and lumbar spine were measured by Dual-energy X-ray absorptiometry (DXA). Dietary data from 24-hour dietary recall and a food frequency questionnaire containing 63 food items were used. The proportions of osteopenia at total femur, femoral neck, and lumbar spine were 37.4%, 54.5%, and 45.4%, respectively. The proportions of osteoporosis at total femur, femoral neck, and lumbar spine were 6.2%, 25.6%, and 34.3%, respectively. Age, anthropometric index including height, weight, and Body Mass Index (BMI), parathyroid hormone, and physical activity were related to BMD, but the relationships were site specific. Total femur BMD was explained by age, weight, parathyroid hormone and intakes of carbohydrate and fruits. Femoral neck BMD was related to age, weight, parathyroid hormone and intakes of riboflavin and fruits. Lumbar spine BMD was associated with age, weight, milk and dairy products, calcium intake, and exercise. These results indicated that adequate intakes of milk and dairy products, fruits, carbohydrate, calcium, riboflavin and exercise as well as weight maintenance might play an important role in maintaining optimum bone health in Korean postmenopausal women.
Absorptiometry, Photon ; Aged ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Dairy Products ; Female ; Femur ; Femur Neck ; Fruit ; Humans ; Milk ; Motor Activity ; Nutrition Surveys ; Osteoporosis ; Parathyroid Hormone ; Surveys and Questionnaires ; Riboflavin ; Spine ; Statistics as Topic

Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies