• Journal of Chest Surgery
• /
• v.56 no.2
• /
• pp.128-135
• /
• 2023

Background: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, often requiring prolonged mechanical ventilation and eventually tracheostomy. Both procedures occur in isolation units where personal protective equipment is needed. Additionally, the high bleeding risk in patients with extracorporeal membrane oxygenation (ECMO) places a great strain on surgeons. We investigated the clinical characteristics and outcomes of percutaneous dilatational tracheostomy (PDT) in patients with coronavirus disease 2019 (COVID-19) supported by ECMO, and compared the outcomes of patients with and without ECMO. Methods: This retrospective, single-center, observational study included patients with severe COVID-19 who underwent elective PDT (n=29) from April 1, 2020, to October 31, 2021. The patients were divided into ECMO and non-ECMO groups. Data were collected from electronic medical records at Ajou University Hospital in Suwon, Korea. Results: Twenty-nine COVID-19 patients underwent PDT (24 men [82.8%] and 5 women [17.2%]; median age, 61 years; range, 26-87 years; interquartile range, 54-71 years). The mean procedure time was 17±10.07 minutes. No clinically or statistically significant difference in procedure time was noted between the ECMO and non-ECMO groups (16.35±7.34 vs. 18.25±13.32, p=0.661). Overall, 12 patients (41.4%) had minor complications; 10 had mild subdermal bleeding from the skin incision, which was resolved with local gauze packing, and 2 (6.9%) had dislodgement. No healthcare provider infection was reported. Conclusion: Our PDT approach is safe for patients and healthcare providers. With bronchoscopy assistance, PDT can be performed quickly and easily even in isolation units and with acceptable risk, regardless of the hypo-coagulable condition of patients on ECMO.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.32 no.3
• /
• pp.189-199
• /
• 2006

Purpose of study: Partial thickness skin graft is the golden standard regimen for full-thickness skin defect caused by burn or trauma. However, in case of extensive burns of more than 50% of total body surface area, the donor site is not sufficient to cover all defects. As a second choice, allograft, xenograft and synthetic materials have been used to treat skin defect. Among them the amniotic membrane(AM) was used as a biological dressing for centuries because of its potential for wound healing. In this study, quantification of EGF in AM and effect of AM-collagen complex on full thickness skin defects was examined. Materials & Methods: The concentration of EGF in fresh, deep frozen and freeze-dried AM was evaluated by ELISA. EGF-R immunostaining was performed in freeze-dried AM. SD rats weighing 250${\sim}$300g was used for wound healing experiment. Three full thickness skin defects(28mm diameter) were made on dorsal surface of SD rat. The control group was covered by Vaselin gauze and AM-collagen complex and $Terudermis^{(R)}$. was grafted in two other defects. Healing area, Cinamon's score were evaluated before biopsy. Grafted sites were retrieved at 3 days, 1 week, 2 weeks and 4 weeks after operation. H & E and Factor VIII immunohistochemical stain was performed to evaluate the microscopic adhesion and structural integrity and microvessel formation. Results: 1. EGF concentration of fresh, deep frozen and freeze-dried AM showed similar level and EGF-R was stained in epithelial layer of freeze-dried AM. 2. At 4 weeks after grafting, the healing area of AM-collagen and Terudermis group was 99.29${\pm}$0.71% and 99.19${\pm}$0.77 of original size. However, that of control group was 24.88${\pm}$2.90. 3. The Cinamon's score of AM-Collagen and $Terudermis^{(R)}$. group at 4 weeks was 15.6${\pm}$1.26 and 14.6${\pm}$3.13 and that of control group was 3.7${\pm}$0.95. Significant difference was observed among control and experimental groups(p<0.05). 4. Histologic examination revealed that AM protected leukocyte infiltration and epithelial migration was nearly completed at 4 weeks. $Terudermis^{(R)}$. group showed mild neutrophil infiltration until 2 weeks and completion of epithelization at 4 weeks. Control group showed massive leukocyte infiltration until 4 weeks. 5. Microvessels were increased sharply at 1 week and control group at 1 and 4 week showed significant differences with $Terudermis^{(R)}$. group of same interval(p<0.05) but no differences were found with AM group(p<0.05). Conclusion: EGF and EGF-R were well preserved in freeze-dried AM. AM attached to collagen acted as excellent biologic dressing which had similar effect with $Terudermis^{(R)}$. AM showed anti-inflammatory action and healing was completed at 4 weeks after full-thickness skin defect.

• The Journal of Korean Society for Radiation Therapy
• /
• v.16 no.1
• /
• pp.51-56
• /
• 2004

The aim of this study is to evaluate the effect of skin dose and PDD by using wounds protecting gauzes or Vaselinespread gauzes. And it was studied that the possibility to substitute custom bolus into gauzes. 4MV photon (CL600C, varian, US), Polystyrene Phantom (30(W) X30(L) X 30(H)) with Markus chamber(PTW, US) were used for dose measurement. This study was distinguished natural gauzes and spread over Vaseline gauzes. We gave variety to the gauze thickness at 5, 10 and 15 sheets respectively. For comparison between using bolus and not that, we had used 1.0 cm thickness bolus so that analyzed surface dose and PDD at the same conditions above mentioned. When maximum point was defined as reference point, surface dose was measured as $35\%$ in open beam. When the gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased as 69, 80 and $91\%$ respectively according to thickness of gauzes. When spread over Vaseline gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased respectively as 98, 100 and $98\%$ according to thickness of gauzes. Also when 0.5 cm bolus and 5 sheets gauzes were composed, surface dose was measured as $98\%$. The gauzes that were attached to skin surface in radiation therapy had been scattering material and contributed increasing surface dose without variation of percentage depth dose. However, if we want to delivery much dose to skin surface then we have to apply many sheets of gauzes to skin surface. Although we get easy that result by bolus or spread over Vaseline gauzes, we have to revise percentage depth dose at calculation. Therefore, if we find pertinent conditions based on measured data that are considered skin dose and patient setup efficiency, to replace custom bolus with gauzes will be helpful to efficient treatment.

• Journal of Korean Biological Nursing Science
• /
• v.5 no.1
• /
• pp.23-33
• /
• 2003

This morphological study was carried out to investigate the healing effect of open and occlusive dressing on rabbit skin wounds. The male white rabbits were given incision wound measuring 1.0cm in length and excision wound measuring $1.0{\times}0.2cm$ respectively on backs. Five rabbits among their received sterilization with beta dine twice a day and kept wound open. Another group of rabbits received sterilization and occlusive dressing with application of 1% sulfadiazine ointment and covering of gauze. The rabbits were observed at 5, 10, and 15 days after dressing with light microscope. The results were as follows. Both incision and excision wounds received open and occlusive dressing respectively revealed formation of scab and regeneration of epidermal epithelial cells at wound margin. The superficial dermis showed infiltration of neutrophils, monocytes, and lymphocytes, fibroblastic proliferation, and edema. On 10 days after opera and occlusive dressing the scab had disappeared and regeneration of epidermal epithelium was completed. The capillaries and inflammatory cells were decreased in number. However, edema and fibroblastic proliferation were more pronounced. On 15 days after opera and occlusive dressing, there were keratinization of regenerated epidermal epithelium, loss of inflammatory infiltration, edema, and capillary proliferation, and increase of fibroblastic proliferation and collagen fibers. The amounts of scars were less in incision wound than of excision one. There were no differences in healing processes between both dressing methods. According to the above results, it was conceived that sterilization of wound is more important in wound healing than dressing method in trivial wounds.

• The Journal of the Convergence on Culture Technology
• /
• v.9 no.1
• /
• pp.725-733
• /
• 2023

The evaluation of functional active ingredients and dyeing effect on cotton fabric using 16 types of natural products water extracts and 50% ethanol extracts, there were differences in color intensity, but 6 types of red, 5 types of yellow, 2 types of orange, and 3 types of green were observed. In general, the color of the 50% ethanol extract was high and clear. As a result of dyeing by immersing cotton gauze in water extracts and 50% ethanol extracts of these natural products for 2 days, the dyeing effect was generally good, and it was observed that there was little fading decrease in color even after drying at room temperature and opening and storing. The pH of the water extracts of 16 natural products ranged from neutral to slightly acidic, with no side effects on the skin. For DPPH free radical inhibition antioxidant effect, the effect of 50% ethanol extract for each sample was better than that of water extract. As for the polyphenol content, the content of the 50% ethanol extract tended to be higher than that of the water extract. Therefore, the purpose of this study was to investigate the correlation between the antioxidant activity of 16 natural extracts and the prevention of female vaginitis.