Over the years, many surgeons have used various natural and synthetic materials to bridge the nerve defect. However, none of these materials has surpassed the effectiveness of the nerve autograft. Among natural materials, a vein graft has been used as conduit for nerve regeneration in both research protocols and clinical situations. Unfortunately, the comparison of various research reports is difficult, for each research has employed a different experimental model and method of evaluation for the study of the nerve regeneration. This study introduced various modifications of the vein graft technique, and investigated several vein graft models in an attempt to find the most effective formulation . Four vein graft models were employed: 1) the empty vein graft, 2) the inside-out pattern vein graft, 3) the vein graft filled with skeletal muscle strips, 4) the inside-out pattern vein graft filled with skeletal muscle strips. Regeneration was assessed with gross appearance, histologic examination and electromyography(EMG). In the vein graft filled with muscle strips, there was the increased axonal diameter, myelin sheath thickness, ratio of myelinated axon to unmyelinated axon, and conduction velocities. The result showed that any vein graft filled with muscle strips is superior to the empty vein graft and the inside-out pattern vein graft model which are not filled with muscle strips. It is concluded that the nerve repair using a vein graft filled with skeletal muscle strips can be effectively employed in the clinical field. Further study should be aimed at the regeneration of a longer distance nerve gap and its clinical application.
Animals ; Autografts ; Axons ; Models, Theoretical ; Muscle, Skeletal ; Myelin Sheath ; Nerve Regeneration* ; Rats* ; Regeneration ; Research Report ; Transplants ; Veins*

Cryptotia is rare in Caucasians but more common in Orientals, particularly in Japanese people, where incidence has been reported as 1:400. The features of cryptotia are the invagination of the upper part of the auricle under the temporal skin and the deformation of the auricular cartilage itself. The principles of the surgical correction are the coverage of skin deficit and the correction of deformed cartilage if needed. For the correction of cryptotia, several methods have been tried. But, inadequate amounts of local tissue often result in undercorrection of the cephalo-auricular sulcus, with a tendency to recurrence of the buried ear. Incision scars, hair line distortion, poor color match of graft and multi-staged operation of tissue expansion are noted as the their shortcomings. Therefore, We have performed Hirose's rotation flap method in 15 cases of the 12 patients that available skin in the inferior part of the cephalo-auricular sulcus is transferred to the upper part where skin is deficient, and satisfactory results were achieved. This method has many advantages that the design is simple and the procedure easy, the required depth of the cephalo-auricular sulcus is achieved, the correction of the cartilage deformity can be carried out with unrestricted access, the hairline is not disturbed by the operation, the scar behind the auricle is not visible, and there is no need for additional skin grafting.
Asian Continental Ancestry Group ; Cartilage ; Cicatrix ; Congenital Abnormalities ; Ear ; Ear Cartilage ; Hair ; Humans ; Incidence ; Recurrence ; Skin ; Skin Transplantation ; Tissue Expansion ; Transplants

PURPOSE: This descriptive study was done to evaluate the attitude and practice of hand-washing by student nurses. METHOD: The subjects of the study were 463 senior and junior undergraduate student nurses and RN-BSN students. The questionnaire was developed by the researchers. Data were collected from Oct. 16 to Dec. 20. 2001. and analysed by SPSS/WIN. General characteristics, attitude and practice were analyzed by frequency and percentage and differences in attitude and practice according to grade and practice setting were analyzed with x2 test, t-test or ANOVA. RESULT: 1) The mean frequency of hand- washing was 6.63. Senior students washed more frequently than junior students. 2) The reasons for non-compliance were 'not being accustomed', 'forgetting', and 'not accessible' 3) The mean time for hand- washing was 23.79 sec., less than the stated appropriate time of 42.18 sec. 4) 90% of the students washed their hands 'after contacting excretions and contaminated items' and few washed 'before giving care to the client'. 5) Most students washed hands rotationally rubbing with soap and water. 6) While washing, they removed their rings more often than their watches. 7) Soap bar (52.8%) and paper towel (69.6%) were most frequently used as decontaminating agent and drying method, but detergent solution (74.2%) and paper towels (60%) were considered as the most appropriate agent and method. 8) Hand-washing was perceived important generally 'to protect from cross-infection', 'to protect one-self' and 'the most cost effective'. 9) All students responded nurses should practice 'hand-washing,'.
Detergents ; Hand Disinfection* ; Hand* ; Humans ; Surveys and Questionnaires ; Soaps ; Students, Nursing

PURPOSE: The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnosticefficiency of FNA. MATERIALS AND METHODS: This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables. RESULTS: The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007). CONCLUSION: The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules.
Biopsy, Fine-Needle ; Cohort Studies ; Korea ; Mass Screening ; National Health Programs ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

PURPOSE: This study aims to investigate the degree of subjective pain and the satisfaction of patients who have undergone an implant treatment using a computer-guided template. MATERIALS AND METHODS: A survey was conducted for 135 patients who have undergone implant surgery with and without the use of the computer-guided template during the period of 2012 and 2013 in university hospitals, dental hospitals and dental clinics that practiced implant surgery using the computer-guided template. Likert scale and VAS score were used in the survey questions, and the independent t-test and One-Way ANOVA were performed (alpha=.05). RESULTS: The route that the subjects were introduced to the computer-guided implant surgery using a surgical template was mostly advices by dentists, and the most common reason for which they chose to undergo such surgery was that it was accurate and safe. Most of them gave an answer that they were willing to recommend it to others. The patients who have undergone the computer-guided implant surgery felt less pain during the operation and showed higher satisfaction than those who have undergone conventional implant surgery. Among the patients who have undergone computer-guided implant surgery, those who also had prior experience of surgery without a computer-guided template expressed higher satisfaction with the former (P<.05). CONCLUSION: In this study, it could be seen that the patients who have undergone computer-guided implant surgery employing a surgical template felt less pain and had higher satisfaction than those with the conventional one, and the dentist's description could provide the confidence about the safety of surgery.
Dental Clinics ; Dental Implants ; Dentists ; Hospitals, University ; Humans ; Patient Satisfaction

Purpose: This study was conducted to evaluate the diagnostic performance of machine learning in differentiating follicular adenoma from carcinoma using preoperative ultrasonography (US). Methods: In this retrospective study, preoperative US images of 348 nodules from 340 patients were collected from two tertiary referral hospitals. Two experienced radiologists independently reviewed each image and categorized the nodules according to the 2015 American Thyroid Association guideline. Categorization of a nodule as highly suspicious was considered a positive diagnosis for malignancy. The nodules were manually segmented, and 96 radiomic features were extracted from each region of interest. Ten significant features were selected and used as final input variables in our in-house developed classifier models based on an artificial neural network (ANN) and support vector machine (SVM). The diagnostic performance of radiologists and both classifier models was calculated and compared. Results: In total, 252 nodules from 245 patients were confirmed as follicular adenoma and 96 nodules from 95 patients were diagnosed as follicular carcinoma. As measures of diagnostic performance, the average sensitivity, specificity, and accuracy of the two experienced radiologists in discriminating follicular adenoma from carcinoma on preoperative US images were 24.0%, 84.0%, and 64.8%, respectively. The sensitivity, specificity, and accuracy of the ANN and SVM-based models were 32.3%, 90.1%, and 74.1% and 41.7%, 79.4%, and 69.0%, respectively. The kappa value of the two radiologists was 0.076, corresponding to slight agreement. Conclusion Machine learning-based classifier models may aid in discriminating follicular adenoma from carcinoma using preoperative US.

Ultrasound (US) elastography is a valuable imaging technique for tissue characterization. Two main types of elastography, strain and shear-wave, are commonly used to image breast tissue. The use of elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of elastography for US breast screening. This article is focused on the role of elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of elastography results are also presented.
Breast* ; Consensus ; Elasticity Imaging Techniques* ; Information Systems ; Mass Screening ; Ultrasonography*