Progress in nursing research to assist patients with severe neurological diseases to turn over and prevent pressure sore / 中国实用护理杂志

This article reviews the nursing care of recent years to assist neurotic patients to turn over to prevent pressure sore. The present situation of nursing research on the prevention effect of pressure sore with different turn over method, different turn over angle, different turn over interval time combined with the nature of mattress and patient's condition were introduced, and the effect of preventing pressure sore with different turn over auxiliary appliance was introduced in order to provide a reference for the development of individual nursing guidelines for neurocritical patients.

Progress in nursing research to assist patients with severe neurological diseases to turn over and prevent pressure sore / 中国实用护理杂志

[Absrtact] This article reviews the nursing care of recent years to assist neurotic patients to turn over to prevent pressure sore. The present situation of nursing research on the prevention effect of pressure sore with different turn over method, different turn over angle, different turn over interval time combined with the nature of mattress and patient's condition were introduced, and the effect of preventing pressure sore with different turn over auxiliary appliance was introduced in order to provide a reference for the development of individual nursing guidelines for neurocritical patients.

Effect of multiparity on bone mineral density, evaluated with bone turnover markers / Efeito da multiparidade sobre a densidade mineral óssea, avaliada por marcadores de remodelação óssea

Abstract Objective: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period. Methods: A total of 91 multiparous (five deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. Results: The mean age of multiparous women was 58.79 ± 7.85 years, and the mean age of nulliparous women was 55.84 ± 7.51. The femoral BMD was 0.94 ± 0.16 and lumbar BMD 1.01 ± 0.16 in multiparous women, femoral BMD was 0.99 ± 0.16 and lumbar BMD 1.07 ± 0.14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65 kg and less. Conclusion: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis.

Resumo Objetivo: Investigar o efeito da paridade sobre a osteoporose por meio da avaliação da densidade mineral óssea, marcadores de remodelação óssea e outros fatores eficazes na avaliação da osteoporose em multíparas (cinco partos ou mais) e nulíparas no período pós-menopausa. Métodos: Foram incluídas neste estudo 91 multíparas (cinco partos ou mais) e 31 nulíparas, todas na pós-menopausa. As pacientes foram entrevistadas para a determinação das características sociodemográficas, história ginecológica, hábitos pessoais, níveis de atividade física e ingestão de cálcio ao longo da vida. A densidade mineral óssea foi medida na região lombar (L1-4) e do colo femoral com a Dexa. Resultados: A média de idade das multíparas e nulíparas foi de 58,79 ± 7,85 anos e 55,84 ± 7,51, respectivamente. Nas multíparas, a DMO femoral e lombar foi de 0,94 ± 0,16 e 1,01 ± 0,16, respectivamente; nas nulíparas, a DMO femoral e lombar foi de 0,99 ± 0,16 e 1,07 ± 0,14, respectivamente. Não houve diferença estatisticamente significativa entre os T-escores femoral e lombar e os valores de DMO dos dois grupos. O T-escore e a DMO lombar mostraram uma diminuição em caso de aumento na duração total da lactação materna em multíparas. Encontrou-se que os fatores de risco independentes para a osteoporose na análise de regressão das multíparas são a duração da menopausa e o peso corporal menor ou igual a 65 kg. Conclusão: Não há diferença entre a densidade mineral óssea de multíparas e nulíparas. As mulheres com menor peso corporal e maior duração da menopausa devem ser acompanhadas com mais atenção para determinar se há desenvolvimento de osteoporose.

Aesthetic Surgical Treatment of the Peri-orbital area in Hansen's Patients / 나학회지

BACKGROUND: Upper eyelid blepharoplasty has become one of the commonly practiced aesthetic operation. This upper eyelid blepharoplasty primarily conducted in aged person, while also addressing aesthetic concerns, include methods to rejuvenate the peri-orbital area and provide unobstructed eyesight. OBJECTIVE: Methods to affect rejuvenation of the peri-orbital area are variable and depend heavily on the patients. This makes evaluation of the patient a critically important component of the treatment process. Upper eyelid blepharoplasty requires treatment of the anterior and posterior lamella structures. Anterior lamella undergone a resection of the skin and orbicularis muscle to reduce the sagging appearance on the anterior surface of the upper eyelid. The retractor structures of the posterior lamella, especially the levator aponeurosis and the Müller's muscle, are advanced, tucked and plicated to the tarsus to add tension as needed to correct the blepharoptosis. This procedure, while also addressing aesthetic concerns, primarily adds tension to reduce or eliminate eyesight obstruction. Methods & Conclusion: These operation methods include : The plication procedures of posterior membranous septum and turn-over orbital septum to 2mm below the tarsus and traditional levartor complex tucking including levator aponeurosis and Müller muscle added. In addition to blepharoplasty and blepharoptosis in aged persons the brow-ptosis may also experience. This drooping of the eyebrow also contribute to eyesight obstruction and should be corrected. In general, treatment consists of a subbrow resection when the brow-lash distance is 25mm or more. When the brow-lash distance is less that 25mm, a supra-brow excision is required to prevent an angry or harsh appearance. However, when using the supra-brow method the possibility of an unwanted visible scar is more likely, a short incision direct brow-lift could be another alternative. But short incision brow-lift procedure can only use under the normal forehead muscle function.

Analysis of the influence of different turning angles on the patients with stroke in acute phase / 中国实用护理杂志

Objective To explore the best turn lateral position angle of the patients with stroke in acute phase. Methods 100 patients with stroke in acute phase weredivided into five groups according to 15 ° ,30 ° 45 ° , 60 ° , 90 ° turn lateral position angle separately and then observed the skin temperature of good location of pressure ulcers of the patients before and after turning over 2 h. The changes of blood pressure, heart rate and the finger tip pulse oxygen saturation were recorded within the turn over 2 hours. Results The skin temperature, blood pressure, heart rate, blood oxygen saturation among the groups had no statistical significance (P>0.05) in the difference turn angle of lateral position.The skin temperature, blood pressure, heart rate, blood oxygen saturation between the groups had no statistical significance (P>0.05) in the same turn angle of lateral position.Conclusions Five different turn lateral position angle have no obvious difference on the vital signs and the skin temperature in patients with stroke in acute phase. It is suggested to adopt the turn lateral position angle of less than 90° from the perspective of biomechanics and patients′comfort.

La modificación covalente de proteínas. Un nivel cualitativamente superior de la información molecular / Covalent Modifications of Proteins. A qualitative higher level of molecular information

Introducción: La información molecular es una propiedad principal de las biomacromoléculas, especialmente proteínas y ácidos nucleicos, que permite la realización de funciones con un alto grado de especificidad. Ella deriva de la variedad en los componentes de las macromoléculas. Objetivo: Demostrar que la modificación covalente de proteínas constituye un nivel nuevo y superior de información molecular. Método: Se analizaron artículos de los últimos 5 años, publicados en revistas nacionales y de circulación internacional, disponibles en las bases de datos HINARI, PubMed y Perii y localizados mediante el sitio www.infomed.sld.cu. Desarrollo: Se exponen los mecanismos y características principales del proceso y posteriormente algunos de los efectos principales de la modificación covalente sobre las funciones y propiedades de las proteínas. Conclusiones: La modificación covalente es un mecanismo que amplía el campo de acción de las proteínas permitiendo un rápido cambio en sus propiedades funcionales y, por lo tanto, constituye un nivel nuevo y cualitativamente superior de información molecular.

Introduction: Molecular information is an essential property of biomacromolecules, especially proteins and nucleic acids. This property allows carrying out specific functions. It derives from variability of macromolecules components. Objetive: To prove that covalent modification of proteins represents a new and higher level of molecular information. Method: Papers published during the last five years in national and international journals were analyzed. These articles are available in HINARI, PubMed, and Perii databases and were localized through www.infomed.sld.cu. Main text: First, the mechanism and features of covalent modifications of protein are presented. Next, the principal effects on protein functions and properties are analyzed. Conclusions: We conclude that covalent modification of proteins represents a new and higher level of molecular information.

Design and analysis of two-way side turn over mechanism for intelligent sanitation nursing instrument / 中国实用护理杂志

Objective To aim at the problem of bedsore which is always occurred on the crowd of the aging population,empty-nest family and the disabled patients etc,a two-way side turn over mechanism for intelligent sanitation nursing instrument is designed.Methods The turn over angle of the mechanism was analyzed and calculated after establishing the mechanism's three-dimensional model.The forces situation of the state of lying,side lean against and left/right side turn over were carried out through finite element analysis by using of Pro/Mechanica.Results The results showed that the sum of two-way side turn over mechanism's two-way side turn over angle was 30 degrees.The materials met the mechanism's force requirement.Conclusions The results can provide a theoretical basis for the designer to determine the structure parameters and sizes of mechanism.

Study of a suitable turn over nursing program for preventing pressure sores in stroke patients / 中国实用护理杂志

Objective To observe the preventing effect of optimal programs (improving turn over postures and elongating the turn over intervals)in preventing pressure sore occurrence in patients with acute stroke. Methods Acute stage stroke patients (time from on-set less than or equal to one week)were selected and divided randomly into 4 groups, one group adopted 2.0 hours turn over intervals as the routine group, others adopted 2.5 hours, 3.0 hours, 3.5 hours turn over intervals as the study groups. The incidence of pressure sores and complications were recorded. Results None of the groups (2.0 h, 2.5 h,3.0 h, 3.5 h)suffered from pressure sores. The incidence of complications including malnutrition, pulmonary infections and constipations was not increased in the study groups either. Conclusions Optimal turn over nursing programs including elongating turn over intervals to 2.5h, 3.0h, 3.5h and adopting 30 degree lateral posture can effectively prevent occurrence of pressure sores in acute stroke patients.

Research in prevention of pressure ulcer for bed-ridden patients by simple turn-over pillow and turn-over mattress / 中国实用护理杂志

Objective To study the prevention of pressure ulcer for bed-ridden patients by simple turn-over pillow and turn-over mattress.Methods Self-made simple turn-over pillow and turnover mattress were used in 1300 patients who had high risk of pressure ulcer,and the application effect was observed.Results No pressure ulcer occurred in 1300 patients when they were discharged.Conclusions Simple turn-over pillow and turn-over mattress showed definite effect to prevent pressure ulcer,they have application value,and are worthy of wide spread.

Concomitant Repair of Annuloaortic Ectasia, Aortic Regurgitation, and Pectus Excavatum in Marfan Syndrome / 日本心臓血管外科学会雑誌

Marfan syndrome may include cardiovascular disease co-exising with thoracic deformities. A 24 year-old man given a diagnosis of Marfan syndrome and annuloaortic ectasia (AAE), aortic regurgitation (Ar) and pectus excavatum, was referred to our hospital due to the rapid dilatation of a root aneurysm. Chest computed tomography showed a root aneurysm measuring about 60×55 mm in diameter with mild Ar. Moreover, the sternum, which had been displaced in a posterior direction, contacted with the root aneurysm and heart. The heart was deviated to the left, because of compression from the sternum. We performed a concomitant repair of AAE and Ar and pectus excavatum with partial sternal turnover and elevation, and Bentall procedure. First, median skin incision was made, and dissected to the sternum. The ribs and cartilage below the third rib were cut, and the sternum was transected at the two-thirds point. The root aneurysm and heart were visible so it was easier to operate than a post median sternotomy. A cardiopulmonary bypass was established by ascending aortic perfusion, right atrial drainage and pulmonary arterial venting. The Bentall procedure was done using a Carrel patch methods. The removed sternum was formed flat and turned over, and sternum elevation was perfomed using sternal wire, after cutting and removing the excess ribs and costal cartilage. The postoperative course was uneventful with good hemodynamic and respiratory function. Concomitant surgery provides good operative exposure, which can avoid accidental aneurysm laceration, although operation time is longer and operative invasion and bleeding are greater than in staged operations.

Expression of minichromosome maintenance protein 3 gene and bone formation-related genes on osteoblasts exposed to excessive fluoride / 中国地方病学杂志

Objective To study the effects of fluoride on minichromosone maintenance(MCM)3 mRNA and the bone formation-related gene:bone sialoprotein(BSP),osteocalcin(OC),osteopontin(OP)mRNA expression on human osteoblast cells.The expression of MCM3 was tested for diagnosis and surveillance value on osteoblast treated with excess fluoride.Methods Human osteoblast cell(Saos-2)was cultured in McCoy5A medium and treated with fluoride(sodium fluoride,NaF).There were eight groups including:0(control),0.625,1.250,2.500,5.000,10.000,20.000,40.000 mg/L groups.Expression of MCM3,BSP,OC,OP mRNA were detected by real-time PCR.Dual-standard curve method was used for analysis.ALPase was determined by measuring the absorbance using a micro titer plate reader. Results Expression of MCM3 mRNA was lower in the 0.625,1.250,2.500,5.000,20.000, 40.000 mg/L groups(0.059 ± 0.003,0.027 ± 0.001,0.272 ± 0.004,0.115 ± 0.002,0.137 ± 0.004,0.754 ±0.002, all P > 0.05) and was higher in10.000 mg/L group(21.300 ± 1.200, P < 0.01 ) than control group( 1.000 ±0.020), especially 10.000 mg/L group was higher than groups treated with fluoride(all P < 0.01 ), the differences among groups were significant(F = 305.842, P < 0.01 ). Expression of BSP mRNA was significantly higher in 0.625,1.250,2.500,5.000,10.000 mg/L groups(71.80 ± 3.60,133.00 ± 7.20,85.50 ± 0.60,80.90 ± 1.20,304.00 ± 21.00)than the control group( 1.00 ± 0.04), especially 10.000 mg/L group was higher than others groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 159.531, P < 0.01 ). Expressions of OC mRNA were higher in 0.625,1.250,2.500,5.000 mg/L groups(110.00 ± 12.00,143.00 ± 2.10,90.60 ± 4.10,23.70±1.20) than control group(1.00 ± 0.01, all P < 0.01), and the differences among groups were significant (F = 158.734, P < 0.01 ). Expression of OP mRNA were higher in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups(167.00 ± 11.20, 111.00 ± 12.10,72.50 ± 3.50,134.00 ± 14.00,42.30 ± 2.40,45.20 ± 3.30) than the control group(1.00 ± 0.04, all P < 0.05 or < 0.01 ), the differences among groups were significant(F = 60.226, P < 0.01 ).Compared with control group(4.2 ± 1.2), the ALPase activity was increased in all groups treated with fluoride (6.0 ± 0.4,5.8 ± 0.1,5.7 ± 0.4,7.7 ± 1.1,19.2 ± 2.4,8.5 ± 3.0,18.1 ± 4.2), but only 10.000 mg/L and 40.000 mg/L groups were higher than control group and other groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 7.806, P < 0.01 ). Conclusions Irregular expression of MCM3 mRNA is not suitable as a diagnostic and monitoring biomarker of osteoblasts exposed to excessive fluoride. Fluoride may affect the osteoblast-related gene expression and to promote osteogenic differentiation.

Study in application of cloth in turning patients over / 中国实用护理杂志

Objective To investigate the clinical application of cloth in turning patients over. Meth-ods 80 emergent patients of long-term bedridden without automtic movement and with spinal cord injury and paraplegia were divided into the observation group and the control group with 40 cases in each group. The ob-servation group used cloth for turning over, while the control group used the traditional free hand turning over method, the advantages and disadvantages of the two groups were compared. Results From the aspects of patients' subjective comfort, skin integrity, the labor intensity of nurses, the observation group was better than the control group. Conclusions Turning patients over with cloth overcomes the pushing, pulling, drnging and other defects of traditional flee-hand method, keep patients feel comfortable and skin integrity and non-dam-aged, nurses feel easy because of less labor and time.

Adipofacial Turn-Over Flap for Reconstruction of the Foot and Ankle

PURPOSE: Various kinds of local flap or free flap have been used for coverage for soft tissue defects with bone exposure over the ankle and dorsum of foot. Adipofascial flaps, nourished by vascular plexuses of the subcutaneous tissue and deep fascia originating from the local perforators of the major vessels, appear particularly to be indicated for the reconstruction of these areas. Our experience with this flap on the dorsum of foot and ankle has also been quite encouraging. METHODS: The design of the flap is determined by the size and the location of the defect. The base of the flap is chosen depending on the availability of the soft tissue around the defect. The ratio of the area of the flap to the area of the base wound be more reliable to predict the survival of the turnover flap by the conventional length-to-width ratio. Nineteen patients with defect over the dorsum of the foot and ankle were resurfaced with adipofascial turn-over flaps and skin graft. RESULTS: The average age of the patients was 38.2 years(3-81 years). The flap size was from 2x3cm to 8x5cm. The average follow-up time was 6 months. All flaps survived completely except one case who suffered distal necrosis of the flap. The additional skin graft was required for partial skin loss in the five cases. Other functional impairment was not noted. CONCLUSION: Dissection of the local adipofascial turnover flap is quite easy, quick, requires less time and sacrifice of surrounding muscle itself, and maintains major arteries. In most cases, donor-site morbidity is minimal with an acceptable scar, and both functional and esthetical results were satisfactory. Therefore, Adipofascial flap could be an option for the difficult wounds around the foot and ankle.

Effect of Ultraviolet Irradiation on Bone Metabolism: Serologic & Radiological Study in Mouse / 대한정형외과연구학회지

PURPOSE: The purpose of this study was to investigate the effects of low energy-ultraviolet B (UVB) irradiation on bone metabolism and turnover in mice. MATERIALS AND METHODS: Five-week old C57BL/6 mice were randomly allocated into two groups. Control group (n=35) was not exposed to UVB and experimental group (n=35) was exposed to low energy-UVB for 30 min a day during 7 days. Serological and radiological examination was performed at 0, 1, 2, 4, 8 week(s) of each group (n=7). RESULTS: Analysis of biochemical bone markers revealed that alkaline phosphatase (ALP) was detected higher in the UVB group compared to control group. Serum level of osteocalcin was higher in UVB group at 1st week after UVB irradiation (p=0.031). The mean value of Vitamin D was significantly higher in UVB group than control group (p=0.032). Bone mineral density (BMD) from both 5th lumbar spine (p=0.124) and femur (p=0.862) showed higher in UVB group than control group from two weeks after irradiation, but they were not statistically significant. CONCLUSION: Our study with radiological bone mineral density and serological tests for biochemical bone turnover markers revealed that ultraviolet irradiation contributed positive effect on bone formation.

Clinical application of turn-over flap

To select the method to cover the soft tissue defect, we should take into account of many factors, such as the location of the defect, the depth and length of the defect, the presence of the osteomyelitis, the exposure of nerve, blood vessel and bone, and so on. As a first choice, primary closure or skin graft can be done. However, with the exposure of tendon, bone, blood vessle and nerve, we should consider local flap, muscle flap, fasciocutaneous flap, musculocutaneous flap and free flap to cover the defect. To make matters worse, it can be happened in some cases that these procedures are even impossible due to debilitating general condition, accompanying other diseases or previous operative scar in neighboring tissue. The authors reconstructed the soft tissue defect elevating the neighboring dermal flap or fasciodermal flap in the fashion of -over flap after deepethelialization in 7 cases of total 6 patients. They had soft tissue defect with varying etiologies and skin graft was done both on the recipient and donor sites of turnover flap in all cases except case 4. With the average 1Z.7 months of follow up period, turn-over flap brought satisfactory results in functional and aesthetic aspects without notable complications in donor and recipient sites, though it has a tendency to leave the recipient site somewhat hypertrophied comparing with neighboring no 1 tissue. In conclusion, turnover flap is an useful one-staged operative procedure and it is simple in design and easy in technique. Furthermore, the operative procedure can be done with the advantage of providing safe and thick skin to the area with a remarkable scar in neighboring tissue after multiple operative procedures or to the case in which it is difficult to do the skin graft, local flap or distant flap due to the technical problems.

Clinical Significance of Bone-Specific Alkaline Phosphatase as a Marker of Bone Turn-Over In Hemodialysis Patients: Impact of Metabolic Acidosis on Various Bone Markers / 대한신장학회잡지

Renal osteodystrophy is a leading cause of morbidity in patients with end stage renal disease(ESRD), including a diverse clinical spectrum and histologic lesions. Since the invasiveness and practical limitations of bone biopsy to diagnose the exact nature of bone disease in ESRD patients, many attempts have been made to investigate the biologic markers of bone disease. Bone-specific alkaline phosphatase(bAP) is localized in the plasma membrane of osteoblast to be involved in bone formation and skeletal mineralization. This study was undertaken to evaluate the value of bAP in the diagnosis of renal osteodystrophy and to examine the correlation between bAP (Immunoassay, Metra, U.S.A.) and other known markers of bone turn-over, total alkalilne phosphatase (tAP), intact parathyroid hormone(iPTH) and osteocalcin in 49 HD patients(M:F 29:20, mean age 51 years, mean HD duration 57 months). We also evaluated the impact of metabolic acidosis, which is known to stimulate the osteoclastic activity and bone resorption, on plasma levels of these bone markers. The median value of bAP in HD patients was 30.1ng/ml with a distribution of 8.8-140.1ng/ml (normal 12-23ng/ml). There was a significant positive correlation between the duration of HD and plasma levels of tAP, bAP, iPTH and osteocalcin. Significant positive correlaton was also observed between iPTH and other markers of bone turn- over-bAP, tAP and osteocalcin. bAP was correlated better with iPTH(r=0.8483, P<0.001) than tAP(r= 0.7588, P<0.01). In the patients group whose arterial blood bicarbonate below 20mEq/L(30 cases), plasma iPTH and bAP were significantly higher compared to the patients with arterial bicarbonate higher than 20mEq/L(19 cases). In conclusion, high bAP can be an useful marker of increased bone turn-over in HD patients. Increased concentrations of iPTH and bAP in patients with metabolic acidosis(arterial bicarbonate below 20 mEq/L) may reflect an increased bone resorption with resultant increase in osteoblast activity. However, a prospective study with alkali supplementation and bone biopsy will be necessary to define the exact role of metabolic acidosis in the development and progression of renal osteodystrophy.

RECONSTRUCTION OF DISTAL LEG AND FOOT USING DISTALLY BASED ADIPOFASCIAL TURN-OVER FLAP

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.

Two-stage Random-Pattern De-epithelialised Turn-over Flap to Manage the Chronic Cavity of the Dorsum of the Foot: Two Cases Reports / 대한정형외과학회잡지

Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.

Shiftwork and Sickness Absence in Korean Manufacturing Industries / 예방의학회지

In order to provide necessary information for better health of workers through understanding the actual status of the industries adopting shift systems. The data were gathered from a stratified random sample of 347(0.5%) firms selected out of about 70,000 manufacturing industries throughout the nation in 1993 stratification during sampling was by industrial group and number of workers. The major findings obtained from 288 firms surveyed completely were as follows: 1. About 20.2% of the 288 firms were adopting shift systems and shiftworkers accounted for about 25.1% of the total work force in 288 firms. 2. The bigger number of workers was, the higher the adopting rate of shift system was. 3. The rate of having welfare facilities such as dining room, commuting bus, washing facilities, and health care room etc. was higher in the industries adopting shift systems. 4. The major industrial groups adopting shift systems were the rubber & plastic goods manufacturing industry (54.1 per 100 firms) and the textile manufacturing industry (44.8 per 100 firms). However the proportion of shiftworkers was higher in the textile manufacturing industry (70.5 per 100 firms) and the electronics industry (57.9 per 100 firms). 5. The most predominant work schedule was the weekly rotating, semi-continuos 2-crew 2-shift system (47.5%). 6. In the industries adopting shift systems, shiftworkefs had an adjusted average of 0.29 spells per 100 workers (O.14-0.45 in 95% C.I) compared to 0.23 spells per 100 nonshift dayworkers (0.15-0.31 in 95% C.I) for 1 month. 7. Also in the industries adopting shift systems, the adjusted average annual turn-over rate of shiftworkers was 13.07 per 100 workers (12.03-14.12 in 95% C.I) compared to 10.18 per 100 nonshift dayworkers(9.53-10.82 in 95% C.I).