Extensive clinical research has demonstrated that the 585-nm pulsed dye laser(PDL) is effective in eradicating port-wine stains(PWS) and telangiectasia with an extremely low incidence of scarring. The successful treatment of laser therapy is based on selective photothermolysis of blood vessels without damaging the normal overlying epidermis. Unfortunately, the native epidermal melanin acts as an optical shield that absorbs the laser light and reduces the heat generated in blood vessels. When melanin absorbs laser light, the resultant temperature increase can induce epidermal blistering. In these patients, the laser treatment dosages must be kept low, often subtherapeutic, to avoid damage to the epidermis and to prevent the possibility of scarring. Cryogen spray cooling of skin may be an effective method for minimizing epidermal thermal injury. The objective of this study is to determine histologically the effectiveness of the cryogen cooling by spraying the skin with a brief spurt of cryogen prior to the laser pulse, so as to reduce epidermal damage (hypo/hyperpigmentation) caused by this laser. We present a histologic study of the thermal response of the skin of the Sprague-Dawley rats to spray cooling in conjunction with 585-nm pulsed dye laser irradiation with 6J/cm. Both treatment sites with and without the use of the cryogen spray were compared. Under light microscope, the epidermal and dermal histologic changes were compared. A significant reduction in epidermal damage was found in study groups using the cryogen cooling without changing the efficacy of the laser treatment statistically. And a significant reduction in healing periods was observed in study groups using the cryogen cooling prior to the laser pulse. This study suggests that cryogen cooling can reduce epidermal damage during PWS treatment with the 585-nm PDL without reducing treatment efficacy. The absence of epidermal damage suggests that precooling with the cryogen may allow the use of higher laser input to expedite clearance without inducing epidermal change.
Blister ; Blood Vessels ; Cicatrix ; Epidermis ; Hot Temperature ; Humans ; Incidence ; Laser Therapy ; Lasers, Dye* ; Melanins ; Port-Wine Stain ; Rats, Sprague-Dawley ; Skin ; Telangiectasis ; Treatment Outcome

PURPOSE: Lawn trimmers are widely used to cut the weeds around graves in South Korea, but they can cause ocular injury. We investigate at the emergency room the incidence and the clinical features of ocular trauma induced by lawn trimmers. METHODS: The authors analyzed 106 patients who visited Konyang University Hospital's emergency room from March 1, 2007, to October 31, 2011, because of ocular trauma caused by a lawn trimmer. Patients were sorted into two groups, severe ocular injury and mild ocular injury. RESULTS: Over a 5-year period, 106 patients with ocular trauma caused by a lawn trimmer underwent clinical study. Most of the patient (103 patients) were males, and the average age of the patients was 51.75+/-11.66 years. The incidence of ocular trauma peaked in the sixth decade of life. Most injuries occurred between July and September. Severe ocular injury developed in 46.2% of all patients. As age increased, so did the severity of the ocular injury. The impacting object was a small stone in 43.4% of all patients. Nobody wore protective gear. The most common diagnosis were corneal abrasion, followed by intraocular foreign body, corneal laceration, and sclera laceration. Fifty-four patients were followed up, and thirty-six patients of them had severe injury. The most common complication was a traumatic cataract. CONCLUSION: Ocular trauma induced by a lawn trimmer is more severe than general ocular trauma. We suggest that everyone using a lawn trimmer should wear protective gear and follow safety guidelines.
Cataract ; Emergencies ; Eye Foreign Bodies ; Eye Injuries ; Foreign Bodies ; Humans ; Incidence ; Lacerations ; Male ; Republic of Korea ; Sclera

PURPOSE: This study was to develop the clinical competency evaluation, and to examine the effects of the developed evaluation by comparing it with existing evaluation on clinical competency, communication skill, and self-efficacy of nursing students. METHODS: Design was a randomized control group post-test design. The subjects were 102 senior nursing students(Experimental group: 48, Control group: 54) at K university in seoul, Korea. The experimental group took the clinical competency evaluation using standardized patients and the control group took the existing evaluation using a doll. The clinical competency and communication skills were measured by evaluators, and self-efficacy was self reported by the nursing students. RESULTS: The experimental group had higher scores in clinical competency, communication skills, and self-efficacy than those in the control group. CONCLUSION: Through these results, practice education of nursing education programs need to activate the clinical competency evaluation using standardized patients.
Education, Nursing ; Humans ; Korea ; Self Report ; Students, Nursing

PURPOSE: In this study differences in levels of performance and importance of nursing jobs were explored in relation to levels of work experience. METHOD: The sample was chosen by convenient sampling (N=363) and a cross-sectional study design was used. Frequencies and percentages were used for descriptive statistics. ANOVA was utilized to examine differences in performance and importance of nursing jobs among three groups of nurses, divided based on levels of work experience (less than 1 year, 1 to 4 years, and 5 or more years). RESULTS: Regarding performance of nursing jobs, novice nurses provided more support for patients, but provided less assessment of patients (i.e., investigation of levels of nutrition and exercise, and observation of verbal, and non-verbal behavior, and levels of cognition). Regarding the importance of nursing jobs, nursing linked to exercise and activities, and post-operative and excretion care were considered to be less important among novice nurses than among experienced nurses. CONCLUSION: Different training programs should be developed and provided to nurses according to levels of work experience. By doing so, it will be feasible to minimize differences in quality of nursing care triggered by different levels of work experience.
Cross-Sectional Studies ; Employee Performance Appraisal ; Hospitals, General ; Humans ; Nursing Care ; Nursing Staff

BACKGROUND AND OBJECTIVES: There are several factors affecting the result of the ossiculoplasty such as the severity of the pathology, the operating technique and the reconstruction material, etc. So far, most of the ossicular materials that have been developed were not perfect and some of the commercialized materials are not suitable for Koreans. We investigated the dimensions of the Korean ossicles and the space between the handle of the malleus and the plane of the stapes in order to standardize the artificial ossicles to fit Koreans. MATERIALS AND METHODS: Sixteen cadaveric Korean temporal bones which did not have any pathology of tympanic membrane and ossicles were used for this study. We dissected the temporal bones and measured the related dimensions of ossicles under a surgical microscope. RESULTS: The dimensions of the part of ossicles are as follows: (1) length (mm),1) malleus head 3.46+/-0.57, neck 0.91+/-0.17, handle 4.40+/-0.29: 2) incus short process 2.42+/-0.35, long process 3.31+/-0.57: 3) stapes head and neck 0.79+/-0.19, height of crura 2.24+/-0.34: (2) diameter (long, short) (mm), stapes head 0.95+/-0.20, 0.73+/-0.11, footplate 2.91+/-0.20, 1.38+/-0.16. The distance between the stapes head and the malleus handle was 3+/-0.3 mm, and between the stapes footplate and the malleus handle 5.1+/-0.4 mm. The angle between a line from the malleus handle to the head of stapes and a perpendicular line of stapes footplate passing the center of stapes head was 29+/-7 degree. The angle between a line from the malleus handle to the stapes footplate and a perpendicular line of stapes footplate passing the center of stapes head was 17+/-5 degree. CONCLUSION: We collected normal data of dimensions of the Korean ossicles from cadaveric temporal bones. The differences in the dimensions between ossicles of the Korean and the non-Koreans were observed. The observed data from this study should be useful in the development of the artificial ossicular materials suitable for the Koreans.
Cadaver ; Head ; Incus ; Malleus ; Neck ; Pathology ; Stapes ; Temporal Bone ; Tympanic Membrane

No abstract available.
Bone Density* ; Gonads*

Photoaging skin occurs as a result of long-term exposure to ultraviolet radiation. In contrast to intrinsic aging, skin changes of photoaging can be reversed by the topical use of skin care products. Several skin care products have now undergone sufficient evaluation and have a well-defined role in our practice. Retin-A and alpha hydroxy acids have a significant number of data available for evaluation; data for Vitamin C and antioxidants are still emerging. We conducted clinical trial to compare the anti-photoaging effects of Rein-A and Vitamin C in 25 women volunteers. Each formulation wes applied daily to the randomly assigned hemifaces over the 8-month study period. Comparative evaluations of anti-photoaging effects were made using subject self-appraisal questionnares, plastic surgeon's assessment, ultraviolet revelations, and histologic examinations. Subject self-appraisal and plastic surgeon's assessment showed predominance of Retin-A over Vitamin C. But both Retin-A and Vitamin C provided objective and subjective improvement in photodamaged facial skin and no significant difference was found between Retin-A and Vitamin C in histologic examinations.
Antioxidants ; Ascorbic Acid* ; Diagnostic Self Evaluation ; Female ; Humans ; Hydroxy Acids ; Skin Aging ; Skin Care ; Skin* ; Tretinoin* ; Vitamins* ; Volunteers

Although Nd:YAG laser(1064nm) showed good reduction effects on treatment of cutaneous hemangioma, its use was limited because of non-selective laser absorption and complications such as scar formation. So, we applied different modalities of Nd:YAG laser for more effective and safe treatment. We applied Nd:YAG laser to 9 patients with hemangioma on upper eyelid, cheek, back, arm, and parotid area from February, 1999 to February, 2002. The age at treatment ranged from 4 months to 4 years. Nd:YAG laser was irradiated both inside of the hemangioma by using a bare fiber through a 16G Tefflon cannula and outside of it by cooling the skin with a ice-cube. Nd:YAG laser was irradiated directly into the lesion through the bare fiber and safely to the skin through the ice cube. The mean number of treatment was 1.8, and the time interval between the next treatment was 4.5 months. The mean follow-up period was 13.5 months. Six patients showed almost full regression. Two patients had surgical excision after laser treatment, and one showed slow regression to be in the clinical observation.
Absorption ; Arm ; Catheters ; Cheek ; Cicatrix ; Eyelids ; Follow-Up Studies ; Hemangioma* ; Humans ; Ice ; Skin

The augmentation of soft-tissue defects in the facial region is a challenging task for plastic and reconstructive surgeons. Numerous materials, both autologous and nonautologous materials including alloplastic implants, have been used for augmentation of soft-tissue defects of the face. Each has its limitations. There is no ideal material for soft-tissue augmentation. Acellular human dermal allograft (Alloderm, LifeCell Corporation, Woodlands, Texas, U.S.A.) combines the benefits of autografts and allografts. Alloderm does not appear to be resolved, it is a much more cost- effective treatment than fat injection, collagen injection, or other treatments that require multiple surgical operations or repeated application. Using Alloderm eliminates the need for creating a donor site. The authors report its use in 13 patients who have soft-tissue defects in the face. No serious complications such as rejection, absorption, dislocation, or extrusion were encountered. Alloderm appears to be an easily handled, safe material to use as an implant for permanent soft-tissue augmentation. Further long-term tudies are warranted to monitor the persistent volume maintenance of Alloderm.
Absorption ; Allografts* ; Autografts ; Collagen ; Dislocations ; Humans* ; Plastics ; Texas ; Tissue Donors

No abstract available.
Glucose Transport Proteins, Facilitative* ; Glucose* ; Humans ; Insulin* ; Metabolome*