• Archives of Aesthetic Plastic Surgery
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• v.23 no.1
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• pp.1-10
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• 2017

Background Creating a natural-looking umbilicus during closure of the donor-site in abdominally based free flap breast reconstruction is a factor of satisfaction for both the patient and surgeon. We present a simple method of umbilical transposition that results in an aesthetic, natural-looking umbilicus. Methods From March 2011 to November 2014, fifty three consecutive female patients received abdominal flap breast reconstruction. Twenty patients (from March 2011 to February 2013) underwent umbilical transposition through a cross like incision in the abdominal flap, with fascial fixation sutures but no dermal flaps. Thirty three patients (March 2013 to November 2014) received umbilical transposition in the following method. An oval-shaped incision is made at the location of the new umbilicus on the abdominal flap. This oval is deepithelialized, and full-thickness incisions are made at the 2, 6, and 10 o'clock directions to create three triangular dermal flaps. These are pulled down to the abdominal fascia using sutures that pass through the umbilical stalk and the abdominal fascia at the 3, 9, and 12 o'clock directions. This results in an umbilical stalk lined with dermal flaps, creates a natural periumbilical concavity, and anchors the abdominal flap inward to minimize tension. The cranial flap enhances superior hooding. Results Patient and surgeon satisfaction, surveyed 2 months after surgery with a satisfaction scoring system, were higher in the dermal flap group. Conclusions The technique using three dermal flaps in an oval skin incision is simple, relatively easy to learn, and results in an aesthetic, natural-looking umbilicus.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.760-763
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• 2022

The dorsal metacarpal artery perforator flap is a flap that rises from the hand dorsum. Owing to its reliability and versatility, this flap is used as a workhorse for finger defect. However, to cover the radial-volar defect of the proximal interphalangeal joint (PIPJ) of the index finger, a longer flap is required than before. Here, we introduce the oblique extended reverse first dorsal metacarpal artery (FDMA) perforator flap to cover the radial-volar aspect defect of the index finger. A 45-year-old man got injured to the radial-volar defect of PIPJ of the left index finger caused by thermal press machine. The wound was 2 × 1 cm in size, and the joint and bone were exposed. We used FDMA perforator from anastomosis with palmar metacarpal artery at metacarpal neck. Since the defect was extended to the volar side, the flap was elevated by oblique extension to the fourth metacarpal base level. The fascia was included to the flap, and the flap was rotated counterclockwise. Finally, PIPJ was fully covered by the flap. Donor site was primarily closed. After 12 months of operation, the flap was stable without complication and limitation of range of motion. The oblique extended reverse FDMA perforator flap is a reliable method for covering the radial-volar defect of the PIPJ of the index finger. This flap, which also has an aesthetic advantage, will be a good choice for hand surgeons who want to cover the PIPJ defect of the index finger using a nonmicrosurgical option.

• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.45-48
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• 2019

Allogenic keratinocyte application is widely used for treatment of second degree burns. However, there is no significant body of report on application of allogenic keratinocyte to third degree burns. A geriatric patient visited our burn center showing second to third-degree burn on dorsum of her left hand. Considering the surface area and wound depth, surgery was indicated but her medical condition and age made the surgery high risk for a long operation. Therefore, chemical escharolysis, serial bedside debridement, and cultured allogenic keratinocyte (Kaloderm^®, Tegoscience, Seoul, Korea) application was done. The wound was completely epithelialized after four rounds of Kaloderm^® application. For third-degree burns where definitive surgical reconstruction is precluded due to medical comorbidity of the patient, we investigated the possibility of allogenic keratinocyte treatment which may allow to avoid high-risk anesthesia and surgery.

• Journal of the Korean Society of Food Culture
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• v.22 no.2
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• pp.289-298
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• 2007

The purpose of this study is to examine the Americans' perception on Korean food by analyzing the articles of the New York Times which is the best quality newspaper in America. The number of articles of the New York Times on Korean food were 111 from 1980 to 2005. The average yearly articles was 1.3 form 1980 to 1989, 4.1 from 1990 to 1999, and 9.5 from 2000 to 2005. A large number of articles(54.1%) concerning Korean foods were restaurant reviews based on the experiences in dining at Korean restaurant in America. Main authors of restaurant reviews were Eric Asimo(14), Florence Fabricant(11), and Mark Bittman(8). The kinds of Korean foods reported in the New York Times were 111 which included staple food(21), subsidiary food(82) dessert(4) and Japanese Food(4). There were 15 recipes on Korean food reported in the New York Times including 3 items on Kimchi and 3 items on Bulgogi. The New York Times said Kimchi, Buigogi, Galbi, Pajeon, and Bibimbop were popular among Americans. The New York Times described Korean foods as exhilarating, robust, bold, rustic, healthful, incendiary, assertive, lusty, and exuberant. There were many favorable comments on Korean foods in the New York Times.

• Journal of English Language & Literature
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• v.57 no.5
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• pp.813-838
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• 2011

Toni Morrison's ninth novel A Mercy delves into the colonial American history of the seventeenth century when Europeans began to migrate to the New World and when the first slaves were brought to Virginia. Morrison presents a diverse group of people such as white Europeans, an American Indian, a free black man, indentured servants, and slaves from Africa in order to explore the subjects of ownership, freedom and racism. She emphasizes the fact that most of the Europeans who came to America in the early seventeenth century were the people who were thrown out from the society such as felons, prostitutes, servants and children. By portraying how these castaways tried to settle in a new environment surrounded by unknown dangers and challenges, Morrison demystifies and reconstructs the myth of the birth of America as a nation state. In continuation of Morrison's writings about love and the betrayal of love, her novel A Mercy explores the subjects of trauma, memory and subjectivity by choosing the topic of motherly love and its betrayal which she dealt with poignantly in Beloved. The female protagonist, Florens, is given away by her mother in partial payment of debt incurred by the owner of Florens's mother. The traumatic memory of Florens's separation from her mother shapes Florence's character. She has to revisit the site of the original traumatic experiences of being given up by her mother in order to reconstruct her fragmented memory and past. The recurring dream of the traumatic incident that takes hold of Florens can be explained by the trauma theory of Freud, Cathy Caruth, Suzette Henke, and Judith Herman. The paper explores the self journey of Florens in which she faces the traumatic past and comprehends its meaning which enables her to construct her subjectivity by understanding the true meaning of being free and of owning oneself. In particular, it demonstrates how the process of writing a confession, a story about one's history, enables one to reclaim the traumatic experience and to locate it in the narrative memory.

• Clinical and Experimental Vaccine Research
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• v.12 no.2
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• pp.97-106
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• 2023

Purpose: Rabies is a fatal but preventable disease with proper pre-exposure anti-rabies vaccination (ARV). Dogs, as household pets and strays, are the reservoir and vector of the disease, and dog bites have been associated with human rabies cases in Sri Lanka over the past few years. However, other susceptible species having frequent contact with humans may be a source of infection. One such species is sheep and immunity following ARV has never been tested in sheep reared in Sri Lanka. Materials and Methods: We have tested serum samples from sheep reared in the Animal Centre, Medical Research Institute of Sri Lanka for the presence of anti-rabies antibodies following ARV. Sheep serum samples were tested with Bio-Pro Rabies enzyme-linked immunosorbent assay (ELISA) antibody kits used for the first time in Sri Lanka and our results were verified by a seroneutralization method on cells (fluorescent antibody virus neutralization, FAVN test) currently recommended by World Organization for Animal Health and World Health Organization. Results: Sheep received annual ARV and maintained high neutralizing antibody titers in their serum. No maternal antibodies were detected in lamb around 6 months of age. Agreement between the ELISA and FAVN test, i.e., coefficient concordance was 83.87%. Conclusion: Annual vaccination in sheep has an effect on maintaining adequate protection against rabies by measurements of anti-rabies antibody response. Lambs need to be vaccinated earlier than 6 months of age to achieve protective levels of neutralizing antibodies in their serum. Introducing this ELISA in Sri Lanka will be a good opportunity to determine the level of anti-rabies antibodies in animal serum samples.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.42 no.1
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• pp.35-44
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• 2024

The purpose of this study is to investigate the garden architectural characteristics of the Villa Medici a Fiesole, which occupies an important place in the Italian Renaissance garden, and it is concluded as follows. First, the Villa Medici a Fiesole was built between 1451 and 1457 for Giovanni, the son of Cosimo, and then owned by many people and came to the present. It was designed by Michelozzo and is the first newly built Renaissance villa to show Alberti's concept of rural residence. Second, the location is the biggest characteristic of the Villa, which was built on the steep slope of the Fiesole and offers a panoramic view of the landscape of Florence. Third, the overall composition of the garden created using the slope is based on three terraces of different heights, and the overall spatial arrangement is made up of an orthogonal axis at which the vertical and horizontal axes intersect around the villa. Fourth, in the case of vegetation and objects, old paulownia, roses, and potted lemon trees are placed on the first terrace on the three lawn flower beds. Fountain and niche are located at the middle and east end of the terrace. The second terrace cannot be reached through stairs, but only through a villa or a ramp outside the door. The second terrace has a wisteria pergola that leads to a secret garden, and in the center of the pergola, there is a staircase that leads to the third terrace. The Secret Garden takes the form of a quarter garden and consists of an oval pond, a coniferous flowerbed, and magnolias. On the third terrace at the bottom, a symmetrically geometric flowerbed spreads out on both sides of a circular fountain, and large lemon trees are in the center of each flowerbed and four magnolias are planted around the fountain.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.2
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• pp.1-8
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• 2009

Purpose: The purpose of this study is to compare degrees of asthenopia in after wearing of dispensed reading glasses with different criterion of P.D. Methods: The person who has minus near correction power (distance correction value (-)) is compared to the degree of asthenopia by wearing of dispensed reading glasses with near P.D(-B) and distance P.D. The person who has plus near correction power is compared to degree of asthenopia by wearing of dispensed reading glasses with near P.D-B, distance P.D, near P.D-A. The "Near-P.D-A" means reduced optical centre distance of reading glasses of positive correction value at which the same effect of prism B.O through near visual point in distance glasses exist at near visual point in reading glasses. Results: When near correction value is (-), dispensed reading glasses with distance P.D have caused less asthenopia than dispensed glasses with near P.D-B. When the near correction value is (+), we cannot confirm that which P.D is more useful for reading glasses. As a result of this study, dispensed reading glasses with near P.D-A have caused less asthenopia than another criterion of P.D. Conclusion: The effect of prism B.I through a near visual point in distance glasses ((-) correction value) reduce convergence demand. Therefore (-) correction value-reading glasses support convergence in near vision, because the effect of prism B.I of reading glasses is smaller than that of distance glasses. When the near correction value is (+), centration points can be determined by one of near P.D-A, near P.D-B, distance P.D.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1213-1217
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• 2015

Background: Gastric cancer is the second most common cause of cancer- related deaths worldwide and ranks $11^{th}$ or $14^{th}$ among all deaths. Patients with advanced disease require supportive care along with the medical and/or surgical treatment. Aim: To assess the need for palliative care for patients with advanced tumours along with standard clinical therapy. Materials and Methods: Eighty-four patients with metastatic (stage 4) gastric cancer, including both patients who had received surgical treatment or not, were followed up in Bagcilar Training and Research Hospital, Division of Medical Oncology between 2011 and 2014. They were categorised as supportive care (-) (Group 1, n=37) and (+) groups (Group 2, n=47) and evaluated retrospectively. Results: Demographic characteristics of the patients were as follows: mean age, Group 1, $65.2{\pm}10.5$ years, Group $2,63.7{\pm}11.3$ years; male/female ratio, Group 1, 21/16, Group 2, 28/19; distribution of Eastern Cooperative Oncology Group (ECOG) performance scores of 0 and 1, Group 1, ECOG 0 (n=9) and 1 (n=14), Group 2, ECOG 0 (34) and 1 (n=13) (p<0.0001); patients receiving second-line, Group 1 (n=7) and Group 2 (n=22) (p<0.008) or third - line chemotherapy,Group 2 (n=6) (p<0.02); mortality rates, Group 1, (n=28; 75.6%) and Group 2 (n=30; 63.8%); progression-free survival (PFS) rates, Group 1, $17.4{\pm}6$ weeks, Group 2, $28.3{\pm}16.2$ weeks; statistically significant overall survival rates, Group 1, $20.8{\pm}8.2$ weeks and Group 2, $28.3{\pm}162$ weeks (p<0.01). Conclusions: The supportive care team (medical oncologist, general surgeon, internal medicine specialist, algologist, psychiatrist and radiologist) can play a role in the treatment of metastatic gastric tumours, with improvements shown in terms of the performance status of cases, eligibility of patients to be on chemotherapy programmes for longer duration and overall survival rates in Turkey.