Local or distant flap surgery has been applied in the soft tissue defect area where bone and tendon are exposed, but there are many pitfalls in these surgeries including limitation of donor site selection, as well as functional and aesthetic dissatisfaction of the donor and recipient site. So these problems have facilitated the development and study of skin substitute (artificial dermis). The history of artificial skin began in the 1980s with the invention of Stage I membrane by Yannas and Burke. Since then it has been developed and applied to chinical cases of extensive burn injury and soft tissue defect. In 1989, and artificial dermis (Terudermis) composed of fibrillar collagen and heat denaturated atelocollagen was developed by Konish. It has the advantage of allowing early-incorporation of cellular and vascular components into its collagen sponge, as well as dehydrothermal cross-linking, which is very weak. This study included 18 consecutive cases which underwent application of artificial dermis on bone and tendon from January 1997 to November 1998. The exposed areas were the result of trauma in 10 cases, postoperative complications in 2 cases, and other causes in 6 cases. The follow-up period ranged from 3 months to 18 months, averaging 11 months. A week after wound debridement and Terudermis application, neovascularization had begun and granulation tissue appeared aften 2-3 weeks. Then the split or full -thickness skin graft was secondarily applied resulting in the production of sufficient skin. In conclusion, Terudermis application to an area of exposed bone and tendon is a very useful method, especially when primary local or distant flap surgery cannot be used. This method is very simple, convenient and reliable.
Burns ; Collagen ; Debridement ; Dermis ; Fibrillar Collagens ; Follow-Up Studies ; Granulation Tissue ; Hot Temperature ; Humans ; Inventions ; Membranes ; Porifera ; Postoperative Complications ; Skin ; Skin, Artificial ; Tendons* ; Tissue Donors ; Transplants ; Wounds and Injuries

No abstract available.
Tonsillectomy*

No abstract available.
Lithotripsy* ; Salivary Gland Calculi* ; Salivary Glands* ; Shock*

29 isoniazid (INH) resistant isolated strains and INH sensitive reference strain (H37Rv) of Mycobacterium tuberculosis were analysed by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) and NciI restriction mapping for the detection of mutations in katG gene and inhA gene. The katG gene was divided into 3 parts (Akat, Bkat, Ckat; each part is about 800 bp) and amplified, inhA gene was amplified as a whole. Each of the amplified 800 bp DNA was digested into small fragments of less than 400 bp with restriction enzymes for the direct PCR-SSCP analysis. Firstly, 10 strains were analysed. All the 10 isolates showed clearly distinct SSCP patterns in Bkat from that of the reference strain, but only two isolates showed distinct SSCP patterns in Akat, and no isolated strain showed any distinct SSCP patterns in Ckat. 10 isolates also showed distinct SSCP patterns in inhA. NciI restriction mapping of Bkat showed mutation in codon 463 in 7 strains among 10 isolated strains. With these results an early detection strategy for the INH resistant M. tuberculosis was applied to the rest of 19 isolated INH resistant strains. Firstly, isolates were screened by Ncsl mapping in Bkat, and 13 strains showed mutations in codon 463. Secondly, the rest of 6 INH resistant isolates were analysed by PCR-SSCP with restriction enzyme digestion (PCR-SSCP-RE) in Bkat, and all the strains showed distinct SSCP patterns from that of the INH sensitive reference strain. This proved our strategy as effective and economic and time saving method in early detection of INH resistant M. tuberculosis.
Codon ; Diagnosis* ; Digestion ; DNA ; Isoniazid* ; Korea* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Restriction Mapping ; Tuberculosis

This paper describes the successful DNA extraction and amplification, and analysis of mitochondrial and Y-chromosomal DNA from an approximately 350-year-old mummy exhumed from Gyunggi-do, South Korea in 2001. Sample tissue was obtained from internal organs such as lung, liver, and muscle of the mummy. Mummy tissue was rehydrated in trisodium phosphate solution, and protein was digested by proteinase K. Sample DNA was extracted using phenol-chloroform-isoamyl alcohol and silica column. Every step of DNA extraction and PCR was cautiously carried out according to general guideline to prevent contamination of the sample DNA. PCR products of mitochondial DNA (mtDNA) were observed with good yield, and sequence analysis of the mtDNA was successfully accomplished in the control regions (HV1, HV2, and HV3). In addition, minimal haplotype Y-STRs were tried to analysis. However, DYS19, DYS389l, DYS390, DYS391, DYS392 and DYS393 were only amplified and clearly genotyped. Sequence analysis of mtDNA and YSTR genotyping were performed more than twice with time intervals, and the results were accepted only when they showed the even profile for authenticating mummy DNA. There are some difficulties in the analysis of DNA from ancient mummified human remains has wellknown problems, such as low template quantity, poor quality of DNA, and the presence of PCR inhibitors. This implies that the most critical factor for ancient DNA analysis is extraction of DNA. In order to overcome these troubles, we used DNA extraction using phenol-chloroform-isoamyl alcohol and silica column and optimized PCR condition. Therefore, the analysis of mtDNA and Y-STRs from mummy was successfully performed.
DNA* ; DNA, Mitochondrial ; Endopeptidase K ; Gyeonggi-do ; Haplotypes ; Humans* ; Korea ; Liver ; Lung ; Mummies ; Polymerase Chain Reaction ; Sequence Analysis ; Silicon Dioxide

The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

Objective: : Traumatic brain injury (TBI) is one of the most common injuries in patients with multiple trauma, and it associates with high post-traumatic mortality and morbidity. A trauma center was established to provide optimal treatment for patients with severe trauma. This study aimed to compare the treatment outcomes of patients with severe TBI between non-trauma and trauma centers based on data from the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods: : From January 2018 to June 2021, 1122 patients were enrolled in the KNTDBS study. Among them, 253 patients from non-traumatic centers and 253 from trauma centers were matched using propensity score analysis. We evaluated baseline characteristics, the time required from injury to hospital arrival, surgery-related factors, neuromonitoring, and outcomes. Results: : The time from injury to hospital arrival was shorter in the non-trauma centers (110.2 vs. 176.1 minutes, p=0.012). The operation time was shorter in the trauma centers (156.7 vs. 128.1 minutes, p0.003). Neuromonitoring was performed in nine patients (3.6%) in the non-trauma centers and 67 patients (26.5%) in the trauma centers (p<0.001). Mortality rates were lower in trauma centers than in non-trauma centers (58.5% vs. 47.0%, p=0.014). The average Glasgow coma scale (GCS) at discharge was higher in the trauma centers (4.3 vs. 5.7, p=0.011). For the Glasgow outcome scale-extended (GOSE) at discharge, the favorable outcome (GOSE 5–8) was 17.4% in the non-trauma centers and 27.3% in the trauma centers (p=0.014). Conclusion : This study showed lower mortality rates, higher GCS scores at discharge, and higher rates of favorable outcomes in trauma centers than in non-trauma centers. The regional trauma medical system seems to have a positive impact in treating patients with severe TBI.

Objective: This study investigated the relationship between trauma scoring systems and outcomes in patients with severe traumatic brain injury (TBI). Methods: From January 2018 to June 2021, 1,122 patients with severe TBI were registered in the Korean Neuro-Trauma Data Bank System. Among them, 697 patients with data on trauma scoring systems were included in the study. According to the Glasgow Outcome Scale-Extended score, the patients were divided into unfavorable and favorable outcome groups. The abbreviated injury scale (AIS), injury severity score (ISS), revised trauma score (RTS), and trauma and injury severity score (TRISS) were evaluated. Results: The AIS head score was higher in the unfavorable outcome group than in the favorable outcome group (4.39 vs. 4.06, p<0.001). ISS was also higher in the unfavorable outcome group (27.27 vs. 24.22, p=0.001). The RTS and TRISS were higher in the favorable outcome group (RTS, 4.74 vs. 5.45, p<0.001; TRISS, 48.05 vs. 71.02, p<0.001). In comparing the survival and death groups, the ISS was lower in the survival group (25.76 vs. 27.29, p=0.036). Furthermore, RTS was higher in the survival group (5.26 vs. 4.54, p<0.001), as was TRISS (62.11 vs. 44.91, p<0.001). Conclusion Trauma scoring systems, including ISS, RTS, and TRISS, provide tools for quantifying posttraumatic risk and can be used to predict prognosis. Among these, TRISS is an indicator of the predicted survival rate and is considered a clinically useful tool for predicting unfavorable and favorable outcomes in patients with severe TBI.

Objective: To compare preventable trauma death rates (PTDRs) in patients with traumatic brain injury before and after the establishment of a regional trauma center (RTC) at a single center. Methods: Our institution established an RTC in 2014. A total of 709 patients were enrolled from January 2011 to December 2013 (before RTC) and 672 from January 2019 to December 2021 (after RTC). The revised trauma score, injury severity score, and trauma and injury severity score (TRISS) were evaluated. Definitive preventable (DP), possibly preventable (PP), and non-preventable deaths were defined as TRISS >0.5, TRISS 0.25–0.5, and TRISS <0.25, respectively. PTDR was the proportion of deaths from DP+PP out of all deaths, and the preventable major trauma death rate (PMTDR) was the proportion of deaths from DP+PP out of all DP+PP. Results: The overall mortality rates before and after the establishment of RTC were 20.3 and 13.1%, respectively. PTDR was lower after the establishment of RTC than before (90.3% vs.79.5%). The PMTDR was also lower after the establishment of RTC than before (18.8% vs.9.7%). The ratio of direct hospital visits was higher in patients before the establishment of RTC than in those after (74.9% vs. 61.3%, p<0.001). Conclusion Establishing the RTC reduced PTDRs. Additional studies on factors associated with PTDR reduction are required.

PURPOSE: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment. MATERIALS AND METHODS: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed. RESULTS: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication. CONCLUSION: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
Cholinergic Antagonists ; Diagnosis ; Female* ; Humans ; Urinary Incontinence*