No abstract available.
Female ; Humans ; Infarction* ; Meningitis*

BACKGROUND: A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. METHODS: Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. RESULTS: A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. CONCLUSIONS: Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.
Carcinoma, Squamous Cell ; Carotid Arteries ; Constriction, Pathologic ; Cutaneous Fistula ; Diagnosis ; Fistula* ; Free Tissue Flaps ; Head ; Humans ; Hypopharynx* ; Incidence ; Myocutaneous Flap ; Neck ; Oropharynx* ; Postoperative Complications ; Radiotherapy ; Retrospective Studies ; Risk Factors* ; Rupture ; Serum Albumin

In the treatment of large hand soft tissue defect including pulp defect, it has been recommended to reconstruct pulp defect separately by glabrous skin flap such as toe pulp free flap or thenar free flap considering of skin texture, color and sensation. But sometimes we may not use recipient digital artery which is required for microanastomosis because of the injury of digital artery. To solve this problem, the authors reconstructed thumb pulp and hand palmar area soft tissue defect with fabricated flow-through chimeric free flap connecting distal part of descending branch of lateral circumflex femoral artery which distributes perforators of anterolateral thigh free flap and pedicle of great toe pulp free flap and met with good results.
Arteries ; Femoral Artery ; Free Tissue Flaps* ; Hand* ; Sensation ; Skin ; Thigh* ; Thumb ; Toes*

It is not easy to decide whether covering soft tissue defect occurred in multiple adjacent fingers with a single, large flap and later secondary division of fingers or cover each digits independently in hand reconstruction. The authors reconstructed soft tissue defect of left second and third finger with medial plantar artery based medialis pedis and medial plantar chimeric free flap and it enabled early rehabilitation without secondary surgery to divide each fingers and get satisfactory result.
Arteries ; Fingers ; Free Tissue Flaps* ; Hand* ; Rehabilitation

Heterotopic ossification is one of the well known complications related to burn and mainly involves major joints and lower extremity, but heterotopic ossification of the hand has been rarely reported. The authors experienced treatment of heterotopic ossification in post-burn scar contracture of the wrist by wide excision with full thickness skin graft and there was no complication such as recurrence. As heterotopic ossification with ulceration is hard to cure with conservative treatment, it must be removed completely by surgical treatment. If ulceration in burn scar of the hand doesn't heal with the conservative treatment, differential diagnosis of heterotopic ossification will be made first.
Burns ; Cicatrix* ; Contracture* ; Diagnosis, Differential ; Hand ; Joints ; Lower Extremity ; Ossification, Heterotopic* ; Recurrence ; Skin ; Transplants ; Ulcer ; Wrist*

Polyurethane (PU) has been widely examined and used for biomedical applications, such as catheters, blood oxygenators, stents, cardiac valves, drug delivery carriers, dialysis devices, wound dressings, adhesives, pacemaker, tissue engineering, and coatings for breast implants due to its mechanical flexibility, high tear strength, biocompatibility, and tailorable foams although bio-acceptability, biodegradability and controlled drug delivery to achieve the desired properties should be considered. Especially, during the last decade, the development of bio-based PUs has raised public awareness because of the concern with global plastic waste for creating more environmentally friended materials. Therefore, it is desirable to discuss polysaccharide (PS)-contained PU for the wound dressing and bone tissue engineering among biobased PUs because PS has several advantages, such as biocompatibility, reproducibility from the natural resources, degradability, ease of incorporation of bioactive agents, ease of availability and cost-effectiveness, and structural feature of chemical modification to meet the desired needs to overcome the disadvantages of PU itself by containing the PS into the PU.

BACKGROUND/OBJECTIVES: (Cheonggukjang) is a traditional fermented soybean paste with significant health-promoting effects. On the other hand, there have been insufficient studies on the safety and efficacy of (Cheonggukjang), which is produced using traditional methods containing toxins and biogenic amines (BAs). This study compared the laxative effect of (Cheonggukjang), containing high or low levels of toxins and BAs (HTBC or LTBC) in a loperamide (Lop)-induced constipation mouse model.MATERIALS/METHODS: To induce constipation, Lop (5 mg/kg) was administered orally to ICR mice twice a day for 4 days, and the dose was increased to 8 mg/kg after a 3-day rest period. (Cheonggukjang) (500 mg/kg, HTBC, or LTBC respectively) was administered for four weeks before the Lop treatment. RESULTS: The number of stools, fecal weight, water contents, gastrointestinal transit, and histological alterations were recovered significantly in the HTBC or LTBC groups. HTBC and LTBC administration did not induce significant changes in body weight, dietary intake, and behavior. The opioid-receptor downstream signaling pathway in colon tissues was also evaluated. The c-Kit, stem cell kinase, and mitogen-activated protein kinases subfamilies, including extracellular signal-regulated kinase 1/2, c-Jun N-terminal kinases, and p38, were all downregulated in the HTBC or LTBC-administered mice colon compared to the Lop group. CONCLUSION These results show that (Cheonggukjang), containing high levels of toxins and BAs, have a similar laxative effect in a mouse model of Lop-induced constipation.

Stroke in young adults has been known to show a lower incidence and a better prognosis. Only a few studies have examined the epidemiology and outcomes of ischemic stroke in young adults and compared them with the elderly in Korean population. All consecutive patients with ischemic stroke visiting 29 participating emergency departments were enrolled from November 2007 to October 2009. Patients with less than 15 yr of age and unknown information on age and confirmed diagnosis were excluded. We categorized the patients into young adults (15 to 45 yr) and elderly (46 yr and older) groups. Of 39,156 enrolled all stroke patients, 25,818 with ischemic stroke were included and analyzed (young adult; n=1,431, 5.5%). Young adult patients showed lower prevalence of most chronic diseases but significantly higher prevalence in exercise, current smoking, and alcohol consumption. Hospital mortality was significantly lower in young adults than elderly (1.1% vs. 3.1%, P<0.001). Higher number of patients in elderly group (68.1%) showed worsening change of modified Rankin Scale than young adults (65.2%). Young adults ischemic stroke showed favorable hospital outcomes than the elderly in Korean population.
Adolescent ; Adult ; Age Factors ; Aged ; Chronic Disease ; Demography ; Disability Evaluation ; *Emergency Medical Services ; Female ; Humans ; Male ; Middle Aged ; *Outcome Assessment (Health Care) ; Prevalence ; Prognosis ; Republic of Korea/epidemiology ; Stroke/*diagnosis/epidemiology/mortality ; Young Adult

PURPOSE: In previous studies, therapeutic hypothermia (HT) in hemorrhagic shock (HS) had beneficial effects on the hemodynamic and metabolic parameters, and on the survival. The mechanism is uncertain. We hypothesized that the suppression of inducible nitric oxide synthase (iNOS) and NF-kappaB could be associated with the beneficial effects of therapeutic HT in HS. METHODS: Sixteen male Sprague-Dawley rats were randomized to normothermia (36~37degrees C, NT group) or moderate hypothermia (27~30degrees C, HT group). They underwent volumecontrolled (2 ml/100 g weight) HS (90 minutes) and partial resuscitation with shed blood (1 ml/100 g). RESULTS: In the HS and post-resuscitation phase, the mean arterial pressures were higher in the HT group than in the NT group and PaO2 was higher in the HT group than in the NT group. The lactate level was lower in the HT group than in the NT group (1.1+/-1.1 nmol/L vs 6.4+/-5.0 nmol/L, p=0.021). Serum concentrations of IL-1 beta and IL-6 and activated p65 NF-kappaB levels in the lung tissue were higher in NT group than in the HT group (p<0.05). Lung malondialdehyde contents and the expression of iNOS mRNA were significantly decreased in the HT group compared to the NT group (63.8+/-6.2 nmol/g vs 44.6+/-4.5 nmol/g, p<0.001; 1313.0+/-924.4 vs 9088.4+/-3984.0 arbitrary units, p<0.001, respectively). CONCLUSION: These data suggest that in HS, therapeutic HT inhibits lipid peroxidation, activation of NF-kappaB, and gene expression of iNOS in the lung. These factors might be the mechanism of the beneficial effects of HT in HS.
Animals ; Arterial Pressure ; Cytokines ; Gene Expression ; Hemodynamics ; Humans ; Hypothermia ; Interleukin-1beta ; Interleukin-6 ; Lactic Acid ; Lipid Peroxidation ; Lung ; Male ; Malondialdehyde ; NF-kappa B ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Resuscitation ; RNA, Messenger ; Shock, Hemorrhagic

BACKGROUND: Recently, childhood obesity has been increased and has resulted in serious health problems. The main purpose of this study was to investigate the prevalence of childhood obesity and its risk factors in elementary students. METHODS: One thousand nine hundred and eleven children were selected from an elementary school in Seoul. We measured children's height, weight, waist to hip ratio, and the obesity rate (%). The risk factors associated with childhood obesity were assessed by a self-written questionnaire answered by their parents. In moderate and severe obese children, we checked their blood pressure, fasting blood glucose, ALT, AST, uric acid, total cholesterol, and triglycerides. RESULTS: The prevalence of childhood obesity was 14.0%. We found that the factors associated with childhood obesity were the number of siblings, class, parent's obesity, and the preference for fish and meat (P=0.030, 0.022, <0.001, 0.003, respectively). In moderate and severe obese children, the prevalence of obesity related diseases was 77.6% and 92.3%, respectively. CONCLUSION: The childhood obesity was strongly associated with parent's obesity and the preference for fish and meat. The prevalence of obesity related diseases was very high in moderate and severe obese children.
Blood Glucose ; Blood Pressure ; Child ; Cholesterol ; Fasting ; Humans ; Meat ; Obesity* ; Parents ; Pediatric Obesity* ; Prevalence* ; Risk Factors* ; Seoul ; Siblings ; Triglycerides ; Uric Acid ; Waist-Hip Ratio ; Surveys and Questionnaires