Background: Chronic stress at work is known to be associated with the risk of developing metabolic syndrome. Recent studies have evaluated stressand its association with metabolic syndrome in specific occupational groups. In the present study, we examined the relationship between stress andthe risk of developing metabolic syndrome in each occupational group. Methods: The present study examined 7,460 Korean workers, aged 20–65 years, whose data were collected from the Korea National Health andNutrition Examination Survey conducted between 2014 and 2016. The information on usual stress awareness was self-reported, and thebiochemical profile of the blood was conducted. The chi-square test and multiple logistic regression analysis were used to investigate therelationship between stress and metabolic syndrome in each occupational group. Results: The metabolic syndrome was prevalent in 26.3% of the study subjects. In the function-related job groups, the individuals with high stress levelsshowed a significantly higher risk of developing metabolic syndrome (odds ratio, 1.625; 95% confidence interval, 1.042–2.534) than those with lowstress levels. An increasing trend was observed, which suggested the increased risk of developing metabolic syndrome across increasing stress levelsin a stratified analysis in many occupational groups, specifically in function-related, viz., manager and expert, office worker, service worker, andsimple laborer (P for trend <0.001) groups. Conclusion The stress levels were significantly correlated with the risk of developing metabolic syndrome in function-related job groups. A differencebetween dose-response association of stress levels and metabolic syndrome existed in each occupational group.

No abstract available.
Carcinoma, Squamous Cell*

Hypopharyngeal reconstruction is a surgically challenging procedure, and postoperative management is important due to a high rate of complications following surgery. In particular, stricture and fistula formation is the most common long-term postoperative complication. Through systematic review and meta-analysis of 21 studies, a significant radiation effect of stricture and fistula formation was found in patients who underwent hypopharyngeal reconstruction. The perioperative radiation must be seen as a critical factor for stricture and fistula formation in hypopharyngeal reconstruction.

Hypopharyngeal reconstruction is a surgically challenging procedure, and postoperative management is important due to a high rate of complications following surgery. In particular, stricture and fistula formation is the most common long-term postoperative complication. Through systematic review and meta-analysis of 21 studies, a significant radiation effect of stricture and fistula formation was found in patients who underwent hypopharyngeal reconstruction. The perioperative radiation must be seen as a critical factor for stricture and fistula formation in hypopharyngeal reconstruction.

PURPOSE: Marjolin's ulcer is rare but highly aggressive malignant cancer that is associated with chronic, nonhealing wounds such as burn wound. There are no confirmed effective protocols for treatment of this disease. This study was conducted to describe the clinical presentation and treatment modalities of Marjolin's ulcer in our hospital. METHODS: This was a retrospective study of Marjolin's ulcer. 20 cases were histologically confirmed malignant skin cancer seen at Chonbuk National University Hospital from January 2000 to December 2011. Data were retrieved from patients' medical records and photographs. RESULTS: The total 20 cases of Marjolin's ulcer were studied. Squamous cell carcinoma was the most common pathological type in 20 patients (100%). Lymph node metastasis at the time of diagnosis was recorded in 3 patient (15%). Wide excision was the most common surgical procedure performed in 17 patients (85%) of cases. The reconstruction modalities were various as free flap 3 patients (15%), skin graft 13 patients (65%), local advancement flap 2 patients (10%) and regional flap 1 patient (5%). Local recurrence was noted in 3 patients (15%) who had surgical treatment. And one patient (5%) expired in hospital. CONCLUSION: Marjolin's ulcer is an infrequent lesion. Unfortunately the diagnosis and treatment are often delayed. If the wound was histologically confirmed, aggressive excision and reconstruction is warranted in these highly malignant skin cancer. Early recognition and aggressive treatment of Marjolin's ulcers are essential to improve outcomes.
Burns ; Carcinoma, Squamous Cell ; Free Tissue Flaps ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Skin ; Skin Neoplasms ; Transplants ; Ulcer

PURPOSE: Incidence of radiographic contrast media extravasation has increased owing to the escalating availability of contrast enhanced imaging. Potential complications of extravasation include localized swelling, itching sensation, hypesthesia, erythema, limitation of finger movement, compartment syndrome, skin sloughing, and necrosis. We describe clinical characteristics and treatment of computed tomography contrast media extravasation. METHODS: A retrospective chart review was performed on 26 consulted patients experiencing contrast extravasation, between January 2005 and December 2011. Age, signs, symptoms, types of contrast administered, volume of extravasation, treatment and patient outcomes were documented and evaluated, retrospectively. RESULTS: Extravasation of less than 100 mL occurred in 85%. Immediate surgical therapy was necessary in 23% of cases. There were no postoperative complications and it rendered excellent cosmetic outcomes. In 77% of cases, conservative management was recommended, such as elevation and immobilization of extremity, application of ice pack, and careful monitoring. CONCLUSION: Prevention is the most important for extravasation injuries. Diagnosis and treatment must be made on the spot in order to avoid severe soft tissue damage. Hand surgeons' decision on the necessity of surgical treatment within 6 hours is important in the prognosis of patients.
Compartment Syndromes ; Contrast Media ; Cosmetics ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials ; Extremities ; Fingers ; Hand ; Humans ; Hypesthesia ; Ice ; Immobilization ; Incidence ; Necrosis ; Postoperative Complications ; Prognosis ; Pruritus ; Retrospective Studies ; Sensation ; Skin ; Upper Extremity

No abstract available.
Lower Extremity*

PURPOSE: Owing to the improvement of microscope, microsurgery implements, and microsuture, finger replantation has made a considerable development. With high success rate of microsurgery in children, positive results have been reported from distal amputation. We report the patients demographics, methods, and results of the microsurgery performed in children in our hospital for the last 8 years. METHODS: From the medical records of 21 patients who had given the treatment in our hospital from January 2000 to December 2007, we analyzed patients' sex, age, operative method, and complication retrospectively. RESULTS: The number of male patients was twice as many as female, where most patients belong to the ages of five to ten years. Operative methods performed in this study included end-to-end anastomosis of artery and vein, vein graft, and epineurial suture. As a result, 19 out of 21 cases were successfully accomplished, and four of them went through the debridement of necrotic tissue due to the partial necrosis of the lesion. A one-year follow-up observation was made after surgery and most of them were almost fully recovered as in their previous state. CONCLUSION: The success rate of finger replantaion in children is continuously improving despite the difficulty of vessel anastomotic procedure, rehabilitation treatment and management after surgery. We report the satisfactory results of pediatric finger replantation technically and aesthetically.
Amputation ; Arteries ; Child ; Debridement ; Demography ; Female ; Fingers ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Male ; Medical Records ; Microsurgery ; Necrosis ; Replantation ; Retrospective Studies ; Sutures ; Transplants ; Veins

PURPOSE: Self-inflicted wrist laceration is a common injury in the department of hand surgery. The aim of this study was to investigate the clinical characteristics and psychiatric features of self-inflicted wrist laceration using categorization according to wound severity. METHODS: We reviewed 71 patients from 2002 through 2012. All of the patients were grouped into four groups. Data regarding the following characteristics were collected: age, gender, size, structure involved, instruments used, history of previous self-inflicted injury, comorbidities in psychiatric and presentation of follow-up outpatient appointment to the department of plastic surgery and psychiatry. RESULTS: In these patients, approximately 64% of patients were female. About 80% of patients cut their wrist using a knife. And in grade 3-4 injury, percentage of glass injury was relatively high (22%), compared with other grades (3%). Unlike previous studies, patients in grade 3-4 tended to cut their wrist repeatedly. Focusing on psychiatric problems, approximately one quarter of patients had a previous history of self-infliction. In all patient groups, mood disorder was the most common disorder in patients who had a previous psychiatric disorder. But after operation, more than two thirds of patients had not visited department of psychiatry again. CONCLUSION: We identified some other differences among their characteristics. All patients in group also should be evaluated and surgically treated properly. A multidisciplinary approach is required for patients with wrist laceration due to self-injury in comparison to those with laceration due to other causes. Because many of them have previous self-injury experiences and psychiatric disease.
Comorbidity ; Female ; Follow-Up Studies ; Glass ; Hand ; Humans ; Lacerations* ; Mood Disorders ; Outpatients ; Retrospective Studies* ; Self Mutilation ; Suicide ; Surgery, Plastic ; Wounds and Injuries ; Wrist*

PURPOSE: An osteoma is one of the common benign tumors that penetrate the nasal portion, paranasal and frontal sinus. This tumor is mostly found by radiation test accidentally, however in rare cases; it can be found to be touched or with its symptoms as the tumor grows. We report this case since we found and healed the benign tumor which was affecting orbit and the both sides of fronal sinus. METHODS: A 19 year old female patient visited to our hospital due to the mass on her forehead. The symptoms began 3 years ago but no special symptom was found except for touchable mass. She was diagnosed as the osteoma of superior orbital parts and both sides of frontal sinus using X-ray and CT scanning. The size of osteoma was 5x2.5x3.5cm and indicated the patterns penetrated to the right side of orbital region. The osteoma excision was conducted with coronal incision and wide area of defect part in frontal sinus and superior orbital part were reconstructed by cranial bone graft and resorbable fixation plates. RESULTS: The patient recovered without any postoperative infections or complications and symptoms. Dysaesthesia was found on her frontal area but improved in 1 month after the surgery. CONCLUSION: The occurrences of osteoma in frontal sinus are rare and can be treated with conservative methods if there are no infections and symptoms. We report this case since we found the benign tumor, which was affecting orbit and the both sides of fronal sinus and healed it with coronal resectomy without any complications.
Female ; Forehead ; Frontal Sinus ; Humans ; Orbit ; Organic Chemicals ; Osteoma ; Transplants