BACKGROUND: With the rapid growth of the elderly population, osteoporosis has become a major health problem worldwide. Although health knowledge and self-efficacy are important assets to facilitate healthy behaviors and disease prevention, such information as it relates to individuals and their bone health is limited. The purpose of this study was to assess the levels of knowledge, self-efficacy, and health behaviors on promoting bone health in middle-aged Korean women. METHODS: This is a cross-sectional survey study. A convenience sampling of middle-aged women (> or =40 years) was done at a community health center in Korea. Bone mineral density was measured by dual energy X-ray absorptiometry with the DEXXUM T. The level of knowledge was measured with the Knowledge of Osteoporosis Scale, and self-efficacy with the Osteoporosis Self-efficacy Scale. A questionnaire for bone health behaviors was developed for this study. Collected data were analyzed through descriptive methods, independent t-test, analysis of variance, and Pearson's correlation analysis. RESULTS: A total of 150 middle-aged women whose mean age was 59.8+/-11.5 years participated in the study. Most (74%) were menopausal. Less than one-quarter of participants (22.7%) had osteoporosis and less than half (42%) had osteopenia based on the T-score at the left femur neck site. Level of knowledge (mean score, 10.35) and self-efficacy (mean score, 47.67) ranged from low to moderate. Intake of calcium and vitamin D-rich foods was insufficient in our subjects. Bone health behaviors had significant positive relationships with knowledge (r=0.22, P=0.008) and self-efficacy (r=0.29, P<0.001) on promoting bone health. CONCLUSIONS: These results indicate that educational interventions are needed to enhance knowledge and confidence and to encourage middle-aged women to engage in bone health behaviors.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Community Health Centers ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Behavior ; Humans ; Korea ; Middle Aged ; Osteoporosis ; Self Efficacy ; Vitamins

BACKGROUND: The criteria established by Light et al in 1972 have been used widely for the differential diagnosis of the pleural effusions in transudates and exsudates. However, in recent years, several reports have agreed that these criteria misclassified an important number of effusions. For this reason, different parameters have been proposed for differentiation the transudates from exudates. Nevertheless, all these alternative parameters have not been better than the past criteria of Light et al. In response the usefulness of two parameters for differentiation pleural transudate from exudates were evaluated : pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio. METHODS: A total of forty-three patient with know causes of the pleura effusion by diagnostic thoracentesis were studied. The following criteria for differentiating the pleural effusions in transudates and exsudates were analyzed : Light's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio. the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. RESULTS: The conditions of forty-three patients were diagnosed. Ten were classified as having transudates and thirty-three as exudates. The percentage of effusions misclassified by each parameter was as follows : Light's criteria, 9.3% ; pleural fluid cholesterol, 2.3% ; pleural fluid to serum cholesterol ratio, 2.3% ; pleural fluid cholinesterase, 4.7% ; and pleural fluid to serum cholinesterase ratio, 2.3%. CONCLUSIONS: The pleural fluid to serum cholinesterase ratio is one of the accurate criteria for differentiating pleural transudates from exudates. If further studies confirm these results, the cholinesterase ratio could be used as the first step in the evaluation of pleural effusion and if evaluated together with the other criteria, the differentiation of pleural transudate from exsudates will become more accurate.
Cholesterol ; Cholinesterases* ; Diagnosis, Differential* ; Exudates and Transudates* ; Humans ; Pleura ; Pleural Effusion

The purpose of this study was to develop a dental communication course in dental hygiene schools that included theory, practice, and skill for effective dental communication. Thirty-six senior dental hygiene students in a dental hygiene school took a dental communication course and responded to a questionnaire. The instrument used in the study was a modified form of Kim's communication skill self-assessment sheet. The self-assessment questionnaire about communication competencies was administered before and after the class, and the difference between scores at each time point was analyzed using the Wilcoxon signed rank sum test. Among seven elements of dental communication competencies, the competency of “information gathering” was significantly improved (p=0.008). Students' scores on perception of the importance (p=0.019) and necessity (0.016) of a communication course significantly increased after the course. Competencies in communication are essential requirement for dental hygienists. This study showed the possibility of communication skill training. An objective evaluation tool regarding students' communication competencies should be developed. Further studies with larger samples size are needed to develop a standardized comprehensive communication course in dental hygiene schools.
Curriculum ; Dental Hygienists ; Health Communication ; Health Education ; Humans ; Learning* ; Oral Hygiene* ; Self-Assessment

PURPOSE: Incomplete syndactyly, due to either congenital or acquired, is uncommon. Many different surgical methods have been descirbed. We introduce the modification of seven flap-plasty for incomplete syndactyly and report functional improvement after correction by modified seven flap-plasty without skin graft. MATERIALS AND METHODS: Twelve patients with an incomplete syndactyly who underwent modified seven flap-plasty were analyzed. Age ranged from one to 40-year-old (average age 21). There were 8 males and 4 females, and the degree of syndactyly was near proximal interphalangeal joint. Two different operative methods were performed. Modification I modified two half-Z flaps in parallelogram shape, and modification II modified V flap of V-M flap in Y-V flap. Functional improvements was measured by maximal abduction distance and maximal abduction angle change. RESULTS: All cases were corrected by using the modified seven flap plasty. Flap tip necrosis was found in two cases of severe burn scar patients, but did not require additional surgery. There was no specific complications. Maximal abduction distance was increased in 6 mm, and maximal abduction angle was increased in 5.8degrees. CONCLUSION: Incomplete syndactyly near proximal interphalangeal joint was corrected by modified seven flap plasty and was able to get a satisfactory result.
Adult ; Burns ; Cicatrix ; Female ; Humans ; Joints ; Male ; Necrosis ; Skin ; Syndactyly

PURPOSE: Given that the critical nature of the microvascular anastomosis to what is often a long and difficult reconstructive operation, trainees need to have a high level of microsurgical competence before being allowed to perform microsurgery on patients. Some artificial substitutes and dead or live animal models have been used to improve manual dexterity under the operating microscope. Yet, most surgeons are not equipped with such models, so search for easy available and appropriate microsurgical practice model have been an issue. Umbilical artery, placental vessels and gastroepiploic arteries have been previously suggested as a microsurgical training model, which involves other surgical departments. The purpose of this article is to introduce that saphenous vein specimen obtained from varicose vein surgery is useful and has many advantages as training model for the practice of microvascular anastomosis. METHODS: The conventional technique using perforation/inversion method with a metallic stripper is widely performed for varicose vein patients. The stripper is inserted through disconnected safeno-femoral junction and retrieved at the knee or the medial side of ankle. The length of saphenous vein specimens removed is about that of one's leg and inversed from inside out. Obtained saphenous vein specimens are re-inversed and cleansed with normal saline, to be readily available for microsurgical practice. Preserved in a squeezed wet saline gauze and refrigerated, frozen or glycerated specimens were investigated into their comparative quality for microsurgical practice. RESULTS: Varicose vein surgery remains one of the common operations performed in the field of plastic surgery. Convenient informed consent regarding the vessel donation can be easily signed. The diameter of the obtained saphenous vein is as variable as 1.5 to 6mm, which is already stripped, and is in sufficient length corresponding to that of patient's leg. Vessels specimens were available for microsurgical practice within 1 week period when preserved with squeezed wet saline gauze, and the preservation period could be extended monthly by freezing it. CONCLUSION: Saphenous vein obtained from varicose vein patients provide with variable size of vessel lumen with sufficient length. The practice can be cost effective and does not require microsurgical laboratory. Additionally there is no need of involving other surgical departments in acquiring vessel specimens. Furthermore, simple preservation method of refrigerating for a week or freezing with squeezed wet saline gauze for a month period, allow the saphenous vein obtained after varicose vein surgery as an excellent model for the microsurgical practice.
Animals ; Ankle ; Freezing ; Gastroepiploic Artery ; Glycosaminoglycans ; Humans ; Informed Consent ; Knee ; Leg ; Mental Competency ; Microsurgery ; Models, Animal ; Saphenous Vein ; Surgery, Plastic ; Umbilical Arteries ; Varicose Veins

PURPOSE: Thumb is the most important part of the hand. That requires reconstruction as a top priority. The operative methods for thumb reconstruction have been developed variously to the microsurgical technique. For better functional and cosmetic effects of the thumb, many studies and reports on toe transfer for thumb reconstruction have been conducted. Great toe transfer for thumb reconstruction was first reported by Cobbett in 1969. Since then, the second toe transfer also has been reported by Dongyue in 1979. Author report about advantages and disadvantages of the second toe transfer for thumb reconstruction. MATERIALS AND METHODS: The second toe transfer had been conducted transfer for nine patients from March 1998 to February 2007. The patient's age ranged from 18 to 52, averaging 30 years old. The levels of defect were classified as two proximal portion of proximal phalanx,five metacarpo-phalangeal joints, and two distal portion of metacarpal bone. The causes of thumb defect were classified as six trauma, two electrical burn, and one malignant tumor cases. The results were evaluated with sensation and strength the reconstructed thumb, cometic effect of recipient site, aesthetic effects at donor sites, and gait problem, at mean 32 months after the operation. RESULTS: After the second toe transfer, the reconstructed thumb's sense was measured as average 8.2 mm at 2 point discrimination test and it's pinching power measured average 81.7% compared to normal thumbs. The degree of cosmetic satisfaction of both donor & recipient sites appeared at 3.4 and 4.7, respectively. CONCLUSIONS: When choosing an operative method for the thumb reconstruction, we have to consider functional and cosmetic effect as well as the socio-cultural background. If we apply the second toe transfer according to the amputation level of the thumb, it would be a good satisfying operative method.
Amputation ; Burns ; Cosmetics ; Discrimination (Psychology) ; Gait ; Hand ; Humans ; Joints ; Sensation ; Thumb ; Tissue Donors ; Toes

Keloid is a scar tissue that undergoes recovery and excessive growth over the original wounds when the collagen is excessively accumulated in the dermis during the wound healing process. The common sites of keloid occurrence include the anterior thorax, shoulder, upper extremities and ear. To our knowledge, however, there are few cases of keloid that occurs in the axilla. In addition, there are fewer cases of keloid that bilaterally occurs at the operated sites postoperatively in individuals with no past or family history. 21-year-old male had undergone subdermal shaving for the management of osmidrosis but had not received appropriate scar management during the military service. He visited us with a keloid-like scar formed in the bilateral axillae. We excised the scar tissue and treated it with local steroid injection and postoperative axilla compression. In histopathological report, no flattening of the overlying epidermis, and presence of keloid collagen which confirms diagnosis of keloid. We report our clinical experience with a rare case of keloid occurring in the axilla and treatment process.
Apocrine Glands ; Axilla ; Cicatrix ; Collagen ; Dermis ; Diagnosis ; Ear ; Epidermis ; Humans ; Keloid* ; Male ; Military Personnel ; Shoulder ; Thorax ; Upper Extremity ; Wound Healing ; Wounds and Injuries ; Young Adult

BACKGROUND: Burn injuries of the extremity can result in cosmetically offensive appearance. Postburn scar can improve by the combination of tangential excision and thin split-thickness skin graft. METHODS: From January 2005 and December 2012, 17 patients (10 males and 7 females) with postburn scar of the extremity underwent the combined techniques. The median time from initial injury to surgery was 66.2 months (range: 11-288 months). In the operation, burn scar was excised until viable dermis could be observed using electrical dermatome, after which thin split thickness skin graft was performed. RESULTS: Tangential excision and thin split thickness skin graft gave excellent grafting results without the need of reoperation. Depigmentation in the majority of patients were recovered within a year by the operation of thin split thickness skin graft. Recovery of range of motion and cosmetic results were good in all patients. CONCLUSIONS: Tangential excision and thin split thickness skin graft are a good way of the reconstruction of deformed and depigmented skin from burns on extremity.
Burns* ; Cicatrix* ; Dermis ; Extremities ; Humans ; Male ; Range of Motion, Articular ; Reoperation ; Skin* ; Transplants*

BACKGROUND: Depressed scars are usually corrected using subcutaneous fillers such a dermal fat grafting or an autologous fat grafting. But, fillers are absorbed over time and cannot be appropriately used for the correction of large or deep depressed scars. Therefore, we tried new methods to correct challenging cases of deep depressed scars. METHODS: From 2005 to 2013, deep depressed scar were corrected in 10 patients. The location of the scars were as follows: 6 neck, 4 lower extremities. Preoperative marking was done involving the scar on the skin in an oval shape including the long axis of relaxed skin tension line, and the epithelium of the scar was removed. Both ends of the dermal layer of the residual scar were dissected and then isolated from the subcutaneous layer of the adjacent skin. Then, we folded both ends of the flap like hinge flaps and thereby appropriately restored the depressed part of the dermal layer. And we directly closed skin for scar revision. RESULTS: All ten patients had a good result and satisfaction without complication, such as wound infection, dehiscence, at a mean follow-up of seven months. Correction of depression area made the depressed scar less noticeable. Moreover, the problems like donor morbidity, color and texture matching in case of using our techniques, are not issued. CONCLUSIONS: We folded residual scar tissue like a hinge flap in the correction of depressed scar. We obtained good outcomes and report our new methods and their outcomes with a review of literatures.
Axis, Cervical Vertebra ; Cicatrix* ; Depression ; Epithelium ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Neck ; Skin ; Tissue Donors ; Transplants ; Wound Infection

Cystadenocarcinoma of the salivary gland is a rare malignant tumor. It was first defined as papillary cystadenocarcinoma in the 1991 World Health Organization (WHO) classification, and it was reclassified as cystadenocarcinoma in the 2005 WHO classification. It is a low-grade neoplasm that features slow growing and predominantly cystic growth. We report a case of cystadenocarcinoma occurring on the parotid gland of a 61-year-old female patient presenting palpable mass on her left cheek. Preoperative examination may not reveal typical malignant characteristics. Such as in our case, the differential diagnosis between cystadenocarcinoma and benign lesion is difficult occasionally. We discuss the clinical and histopathological features of cystadenocarcinoma with the review of the literature.
Cheek ; Cystadenocarcinoma* ; Cystadenocarcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Parotid Gland ; Salivary Glands ; World Health Organization