• 제목/요약/키워드: Increase in morbidity

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Oblique Axis Hypothenar Free Flaps: Tips for Harvesting Larger Flaps with Minimal Donor Site Morbidity

  • Sang Ho Oh;Jae In Chung
    • Archives of Plastic Surgery
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    • 제50권3호
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    • pp.279-287
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    • 2023
  • Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm2. There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.

음양변증(陰陽辨證)의 정의와 기능 및 판별방법 연구 (Definition, Role and Method of Yinyang Pattern Differentiation)

  • 지규용;박신형
    • 동의생리병리학회지
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    • 제35권2호
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    • pp.47-55
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    • 2021
  • In order to ensure the fact that eight principle pattern differentiation is used clinically as a basic guideline for Korean medicine practice, the definition, role and method of yin-yang pattern differentiation with its case report were explored at first. Yinyang Pattern Differentiation is a method of discriminating human tendencies or morbidity based on the yin and yang characteristics expressed in living bodies. And yin and yang are the two contrasting characteristics and aspects of the interaction when certain physical conditions that have a lasting effect on the human physiological metabolic function are correlated with the morbidity. Specific methods of yinyang pattern differentiation can be divided into several types of yin and yang indicators. First, time and space factors like day and night, hot and cold seasons, above and below, topographical districts. Second, colors and pulse and their/or relative clearness and muddiness, hardness and softness, moving and resting. Third, diagnose yin and yang patterns through distinguishing the true and false of a fever and cold in an emergency phase such as increase of brain pressure and shock state. Fourth, general characteristics of the propensity and constitution of a subject such as body type, speech, behavior, and physiological metabolism. And for clinical use, these were summarized again as a symptom indicators of physical signs and color, pulse, tongue and questionnaire indicators of propensity, body type, and space-time characteristics. Conclusively, it was confirmed that yinyang pattern differentiation has its own diagnostic significance which is distinct from exterior-interior, cold-heat and deficiency-excess pattern differentiation.

Home mechanical ventilation in children with chronic respiratory failure: a narrative review

  • Soyoung Kwak
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.123-135
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    • 2023
  • Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient's individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

Relationship between Urbanization and Cancer Incidence in Iran Using Quantile Regression

  • Momenyan, Somayeh;Sadeghifar, Majid;Sarvi, Fatemeh;Khodadost, Mahmoud;Mosavi-Jarrahi, Alireza;Ghaffari, Mohammad Ebrahim;Sekhavati, Eghbal
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.113-117
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    • 2016
  • Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (${\beta}$=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (${\beta}$=0.048, p-value<0.001), for prostate cancer the 95th percentile (${\beta}$=0.55, p-value<0.001), for lung cancer was in 95th percentile (${\beta}$=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (${\beta}$=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(${\beta}$=0.003, p-value<0.001), for esophageal cancer the 95th (${\beta}$=0.04, p-value=0.4) and for skin cancer also the 95th (${\beta}$=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.

Reevaluation of the Metabolic Essentiality of the Vitamins - Review -

  • McDowell, L.R.
    • Asian-Australasian Journal of Animal Sciences
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    • 제13권1호
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    • pp.115-125
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    • 2000
  • In recent years a great deal of information has accumulated for livestock on vitamin. function, metabolism and supplemental needs. The role of the antioxidant "vitamins" (carotenoids, vitamin E and vitamin C) in immunity and health of livestock has been a fruitful area of research. These nutrients play important roles in animal health by inactivating harmful free radicals produced through normal cellular activity and from various stressors. Both in vitro and in vivo studies showed that these antioxidant vitamins generally enhance different aspects of cellular and noncellular immunity. A compromised immune system will result in reduced animal production efficiency through increased susceptibility to diseases, thereby leading to increased animal morbidity and mortality. Vitamin E has been shown to increase performance of feedlot cattle and to increase immune response for ruminant health, including being beneficial for mastitis control. Vitamin E given to finishing cattle at higher than National Research Council (NRC) requirements dramatically maintained the red color (oxymyoglobin) compared with the oxidized metmyoglobin of beef. Under commercial livestock and poultry production conditions, vitamin allowances higher than NRC requirements may be needed to allow optimum performance. Generally, the optimum vitamin supplementation level is the quantity that achieves the best growth rate, feed utilization, health (including immune competency), and provides adequate body reserves.

측두하와에 발생한 법랑모세포종 1예 (A Case of Ameloblastoma in the Infratemporal Fossa)

  • 김강현;이상민;백소야;박영민
    • 대한두경부종양학회지
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    • 제31권2호
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    • pp.49-53
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    • 2015
  • Ameloblastoma is the most common benign odontogenic tumor, with approximately 80% arising in the mandible and the remainder in the maxilla. However, the infratemporal fossa is a rare site in which ameloblastomas occur. Although malignant transformations or metastasizing processes are extremely rare, tumor recurrence is common, if the tumor is not completely resected. Because reoperation could deteriorate quality of life in the patients and increase surgical morbidity, radical surgery is often recommended to minimize recurrence rates. In this report, we presented our experience of resection of ameloblastoma in the left infratemporal fossa with sufficient safe margin through a lower cheek flap approach and marginal mandibulectomy.

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식도 폐쇄 및 기관식도루와 성대문밑협착을 동반한 신생아에서 기관 삽관후 발생한 기관 손상의 보존적치료 경험 1예 (Conservative Management of Tracheal Injury After Endotracheal Intubation in a Neonate with Subglottic Stenosis and Esophageal Atresia with Tracheoesophageal Fistula)

  • 정은영;최순옥;박우현
    • Advances in pediatric surgery
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    • 제16권1호
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    • pp.37-42
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    • 2010
  • Tracheal injury is a rare complication of endo-tracheal intubation. However in neonates, the rates of morbidity and mortality are high. Recommendations for treatment are based on the several reports of this injury and are individualized. Conservative management can be effective in some cases. We describe the case of a neonate who presented with subcutaneous emphysema after intubation in a neonatal intensive care unit. This patient suffered full VACTERL syndrome and had 1.7 mm diameter subglottic stenosis. Conservative management resulted in no further increase in subcutaneous emphysema and after 10 days the patient was stable.

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Interstitial Lung Disease and Diffuse Alveolar Hemorrhage, the Two Key Pulmonary Manifestations in Microscopic Polyangiitis

  • Kim, Min Jung;Shin, Kichul
    • Tuberculosis and Respiratory Diseases
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    • 제84권4호
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    • pp.255-262
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    • 2021
  • Microscopic polyangiitis (MPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated necrotizing vasculitis, which mainly affects small vessels in various organs, especially the lungs. The two key pulmonary manifestations, interstitial lung disease (ILD) and diffuse alveolar hemorrhage (DAH), increase the morbidity and death rate of patients with MPA. ILD is more common in MPA than in other ANCA-associated vasculitis subsets and is primarily associated with myeloperoxidase-ANCA. Unlike alveolar hemorrhage due to pulmonary capillaritis, ILD can initially manifest as isolated pulmonary fibrosis. Of note, its most frequent radiographic pattern is the usual interstitial pneumonia pattern, similar to the characteristic pattern seen in idiopathic pulmonary fibrosis. In this review we present the pathogenesis, clinical manifestations, and radiographic and histopathologic features of ILD and DAH in MPA. We also briefly summarize the outcome and therapeutic options for the two conditions.

Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • 제85권4호
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    • pp.313-319
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    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

Pathogenic and immunological properties of alcohol dehydrogenase in Streptococcus pneumoniae

  • Park, Sin-Hee;Kwon , Hyog-Young;Park, Moo-Hyun;Lee, Kwang-Jun;Kim, Ki-Sang;Pyo, Suhk-Neung;Rhee , Dong-Kwon
    • 대한약학회:학술대회논문집
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    • 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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    • pp.335.2-335.2
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    • 2002
  • Despite the use of antibiotics and vaccines, Streptococcus pneumoniae remains a serious cause of morbidity and morality in human. In this study, pathogenic and immunological natures of alcohol dehydrogenase (ADH) in S. pneumoniae were elucidated. In vitro cytotoxicity test determined by lactate dedydrogenase release from A549 cells revealed that adh mutation significantly reduced cytotoxicity although in vivo intraperitoneal challenge of the adh mutant to BALB/C mouse exhibited marginal increase of survival time than the wild type. (omitted)

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