• Environmental Analysis Health and Toxicology
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• v.31
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• pp.19.1-19.7
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• 2016

A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone /methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.2
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• pp.29-46
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• 2013

A survey conducted on 1,103 patients or caretakers visited Korean medical clinics and hospitals between August 25, 2011 to September 30, 2011 by the Ministry of Health and Welfares and Korea Institute for Health and Social Affairs was analyzed and obtained following results: 1. For sociodemographic distribution, female(813) outnumbered male(290) patients with majority of patients ranging from 30s to 60s. Married patients(793) outnumbered unwed(150) patients and 65.0% with higher than high school education. Statistical significance was seen in gender, age, marital status, and education level but no significant difference for status of employment, income level, and types of insurance between the clinics and hospitals. (P<0.05). 45.1% had less than \2,000,000 in monthly salary and most of coverage was provided by either regional or work insurance. 2. 67.9% of the patients rated health conditions to be better than average and 32.1% listed as poor. People in good health showed tendency to visit Korean medical facilities. Musculo-skeletal conditions such as arthritis, ankle sprain, lumbago, muscular injury, and frozen shoulder were common conditions, followed by gastric disorders, common cold and herbal tonics. No significant difference was observed between the clinics and hospitals for above conditions, but significance was seen in atopic dermatitis, stroke, and sequela from traffic accidents (P<0.05). 3. Ten most common conditions addressed at Korean medical facilities were lumbago, arthritis, muscular injury, back sprain, gastric disorders, ankle sprain, common cold, herbal tonics, frozen shoulder and stroke. Major treatment modalities rendered were herbal medicine, herbal supplements, acupuncture and moxibustion, cupping, tuina, and Korean midical physical therapy. No significant difference existed between the clinics and hospitals. 4. All modalities showed at least 85% effectiveness. No statistical significant difference between the clinics and hospitals except for herbal decoction. (P=0.0452) 5. 88.3% of responses showed treatment satisfaction with significant difference between the clinics and hospitals (P=0.002). The occurrence of side effects was at 2%, mostly corning from treating digestive, skin, kidney disorders and neurological issues. No significant difference was observed between the clinics and hospitals. From the above results, the typical population visiting Korean medical facilities can be summarized as being middle aged female with relatively higher education and moderately low income. The health condition is generally good and the purpose of visit is to receive traditional treatments of acupuncture, herbal medicine, and physical therapy. Treatment efficacy and satisfaction were high with no significant differences between the clinics and hospitals.

• Archives of Plastic Surgery
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• v.39 no.2
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• pp.118-123
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• 2012

Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.311-316
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• 2007

Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.121-126
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• 2009

Purpose: We investigated the clinical characteristics and demographics of patients who suffered from hydrofluoric acid chemical injury and the mechanism of damage. Methods: We retrospectively reviewed the medical records of patients who were exposed to hydrofluoric acid from March 2004 to March 2009 and who were seen at the emergency centers in two university teaching hospitals. Results: Forty four patients out of 47 patients suffered from chemical burn, while the injuries of the remaining 3 could not be identified by the medical records. A total of 17 hydrofluoric acid chemical injury patients were enrolled during the study period, and their mean age was $29.6{\pm}7.0$. All the patients were accidentally injured by contact with the material and none of them inhaled or ingested the material. Only 6 patients wore appropriate protective equipments and 5 underwent the water irrigation for more than 10 minutes. The most common exposure area was the hand and forearm (70.5%). Less than 1% of all of the patients had their total body surface (TBS) exposed to hydrofluoric acid (mean=0.35%). The mean time interval from calcium gluconate administration to pain relief was $33.6{\pm}8.8$ hours. Conclusion: When exposed to hydrofluoric acid, it is important to wear protective equipment and undergo water irrigation for more than 10 minutes. Pain and skin damage were observed in all the patients. After treatment, we concluded that administration of calcium gluconate and pain killers was successful in relieving pain, and the prognosis was also positive for the admitted and followed up patients when less than 1% of the TBS was exposed.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.10 no.1
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• pp.209-246
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• 1997

In the literatual study on the Ecthyma, the results were as follows. 1. The pathogenic factors of Ecthyma is divided three parts. One is exogenous pathogenic factors which including the wind evil, wind heat and toxic material produced by wetness evil. Another is endogenous pathogenic factors which including the declination of kidney-yang, impairment of the liver and kidney, the lower classes of yin-fire, accumulation of wetness-heat in the spleen asthenia, impairment of the liver and kidney, wetness-heat of three yang, asthenic heat-syndrome of three yin. The other is pathogenic factors neither endogenous nor exogenous which including the food and living, uncontrol sexual excess, anxiety and angry, injury of skin, injury of insects and animals. 2. Five viscera which was concerned with Ecthyma are liver, spleen and kidney. 3. Frequent region of Ecthyma are S-36(足三里) and C-7(陰交). External Ecthyma was rose to wetness-heat of three yang channel that cured easily. Internal Ecthyma was rose to asthenic heat-syndrome of three yin channel that cured hardly. 4. In the frequency of prescription, the most numerous prescription is Bojungikgitang(補中益氣湯) and the next are Kyukgigo(隔紙膏) and Yukmijihwanghwan(六味地滉丸). 5. In the frequency of medicine, the most medicine is Calomelas(輕粉) which included Hydrargyrum(水銀) and the next are Olibanum(乳香) and Resina Commiphorae Myrrhae(沒藥) which regulating vital energy and pain control medicine used that in order to destroy insects and remove polson. 6. In classification of the medical action, medicine of clearing away summer-heat and heat evil and activating blood circulation to dissipate blood stasis used to be very busy which in order to remove the disorder of vital energy for virulent heat-evil. 7. In classification of four characters, the most part is warm medicine, the next are cold and cool medicine and there is a few that is hot medicine. 8. In classification of five tastes, the most numerous tastes are bitter and acrid, the next are sweet, salty and sour tastes. 9. In classification of virulence of medicine, the most part is non-toxic, the next are weakly and deadly poison. 10. In classification of channel distribution, the most is the medicine that belongs to liver channel, the next are the lung, spleen, stomach and kidney channel.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.3
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• pp.111-115
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• 2014

Purpose: This study evaluated powdered burn wound dressing materials from wild silkworm fibroin in an animal model. Methods: Fifteen rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of rats under anesthesia. In the two experimental groups, the wounds were treated with two different dressing materials made from silkworm fibroin. In the Control Group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days and 14 days. Wound healing was evaluated by histologic analysis. Results: By gross observation, there were no infections or severe inflammations through 14 days post-injury. The differences among groups were statistically significant at seven days and 14 days, postoperatively (P<0.037 and 0.001, respectively). By post hoc test, the defect size was significantly smaller in experimental Group 1 compared with the Control Group and experimental Group 2 at seven days postoperatively (P=0.022 and 0.029, respectively). The difference between Group 1 and Group 2 was statistically significant at 14 days postoperatively (P<0.001). Group 1 and control also differed significantly (P=0.002). Group 1 showed a smaller residual scar than the Control Group and Group 2 at 14 days post-injury. Histologic analysis showed more re-epithelization in Groups 1 and 2 than in the Control Groups. Conclusion: Burn wound healing was accelerated with silk fibroin spun by wild silkworm Antheraea pernyi. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials can be used for treatment of burn wound.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.4
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• pp.835-841
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• 2007

The followings are concluded from the treatment of headache in Hyungsang medicine, focussed on 11 kinds of headaches in Donguibogam. Headache is classified into overall headache and migraine according to the affected region. The causes are divided into exogenous affection and internal injury; The former brings on headache due to Wind-Cold and headache due to Damp-Heat. The latter, reversal headache, headache due to adverse rising of phlegm, headache due to regurgitation of Gi, headache due to excessive Heat, headache due to excessive Damp, true headache, and alcoholic headache. Headache due to internal injury generally tends to show deficiency syndrome with external affection. Headache due to exogenous affections is common to those who have big head or white skin and to Bangkwang type, and woman. The primary causes are Wind-Cold and Wind-Heat. When the body is observed in the perspective of eight phases, Damp-Heat is to be produced in the front, and Dry-Damp, in the back. Headache due to Damp-Heat is susceptible to Yangmyeong meridian type whose body develops more in the front and to woman. In the perspective of the upper and the lower, Yangdu(that is, head) is related to Eumdu(that is, glans of penis). Headache is also caused by the problems of Eumdu ,such as deficiency of Essence in man, pathologic change of uterus in women, and San syndrome in lower abdomen. In the case of man, headache is frequently severe and difficult to treat because head is a root for man. Disharmony of Gi and blood between the right and the left brings out migraine and headache due to regurgitation of Gi. Migraine is usually accompanied by symptoms of exogenous affection and often afflicts Gi-type, Shin-type, Soyang meridian type, deer type, and Dam-type. Headache due to regurgitation of Gi is brought by Gi deficiency or blood deficiency so that symptoms of exogenous affection do not show. It is mainly common with old people and those who have sunken eyes induced by deficiency of stomach Gi. In the perspective of the upper, the middle, and the lower, the pathologic change of head, chest and abdomen also bring about headache. The pathologic cause of head is Wind-Heat ,which triggers overall headache, migraine, headache due to Wind-Cold, headache due to excessive Heat, The pathogen of chest is phlegm-Fire and brings out headache due to Damp-Heat and headache due to adverse rising of phlegm. The pathologic factor in abdomen is Cold-Damp and produces headache due to adverse rising of phlegm and headache due to excessive Damp. In case of women, headache is generally caused by phlegm-Fire and retention of undigested food.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.635-644
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• 2018

This descriptive study examined the practical nursing guidelines for the prevention of pressure injuries (PI) in operating rooms and their application. Method: Four general hospitals and three specialized hospitals located in Seoul, Incheon, and Gyeonggido province were selected through an online randomization program and nurses at these hospitals who participated in operations and had at least six months work experience were surveyed. Data were collected from January to April 2018 through a survey distributed to 150 nurses, 129 of whom returned the survey (86% recovery rate). The results showed that 43 nurses provided PI prevention care for patients in a lateral position (33.3%), 37 for patients in a supine position (28.7%), and 36 for patients in a prone position (27.9%). Gel was most widely used as the supporting surface material (102 nurses; 79.1%), followed by sponge (62 nurses; 48.1%), and cotton (47 nurses; 36.4%). Skin was often inspected twice, before and after the use of a supporting surface (90nurses; 69.8%), but no designated tool was used to determine the risk of PI developing (76 nurses; 58.9%). Additionally, the patient's position during surgery (83 nurses; 64.3%) and the length of the operation (i.e., more than two hours, in this case) (49 nurses; 38.0%) were determining factors for whether to use a supporting surface. The operating room nurses used the gel, sponge, and cotton as the supporting surfaces for the prevention of PI and confirmed that the cutoff operation time for the use of a supporting surface was more than 2 hours.