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101.
Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.
Graphical Abstract
相似文献102.
Sukhyun Kang Young Kyu Jeong Kyung Hwan Jung Yong Son Sung-Churl Choi Gae Seok An Hyuksu Han Kang Min Kim 《RSC advances》2019,9(66):38447
Graphite is economic and earth-abundant carbon precursor for preparing graphene quantum dots (GQDs). Here, we report a facile and green approach to produce GQDs from graphite flakes via a pulsed laser ablation (PLA) method assisted by high-power sonication. A homogeneous dispersion of graphite flakes, caused by high-power sonication during PLA, leads to the formation of GQDs following a laser fragmentation in liquid (LFL) rather than laser ablation in liquid (LAL) mechanism. The final product of GQDs exhibits the distinct structural, chemical, and optical properties of pristine graphene itself. However, graphene oxide quantum dots (GOQDs) with abundant surface oxygen-rich functional groups are readily formed from graphite flakes when high-power sonication is not employed during the PLA process. GQDs and GOQDs show a significantly different luminescence nature. Hence, selective production of either functional GQDs or GOQDs can be achieved by simply turning the high-power sonication during the PLA process on and off. We believe that our modified PLA process proposed in this work will further open up facile and simple routes for designing functional carbon materials.The proposed technique enables selectively producing graphene quantum dots (on-GQDs) and graphene oxide quantum dots (off-GOQDs) by depending on the applying sonication during the pulsed laser ablation process. 相似文献
103.
Simone CS Wolfkamp Caroline Verseyden Esther WM Vogels Sander Meisner Kirsten Boonstra Charlotte P Peters Pieter CF Stokkers Anje A te Velde 《World journal of gastroenterology : WJG》2014,20(10):2664-2672
AIM:To investigate if the presence of relevant genetic polymorphisms has effect on the effectual clearance of bacteria by monocytes and granulocytes in patients with Crohn’s disease(CD).METHODS:In this study,we assessed the differential responses in phagocytosis by measuring the phagocytic activity and the percentage of active phagocytic monocytes and granulocytes in inflammatory bowel disease patients as well as healthy controls.As both autophagy related like 1(ATG16L1)and immunityrelated guanosine triphosphatase gene are autophagy genes associated with CD and more recently nucleo-tide-binding ligomerization domain-containing protein2(NOD2)has been identified as a potent inducer of autophagy we genotyped the patients for these variants and correlated this to the phagocytic reaction.The genotyping was done with restriction fragment length polymorphisms analysis and the phagocytosis was determined with the pHrodo?Escherichia coli Bioparticles Phagocytosis kit for flowcytometry.RESULTS:In this study,we demonstrate that analysis of the monocyte and granulocyte populations of patients with CD and ulcerative colitis showed a comparable phagocytic activity(ratio of mean fluorescence intensity)between the patient groups and the healthy controls.CD patients show a significantly higher phagocytic capacity(ratio mean percentage of phagocytic cells)compared to healthy controls(51.91%±2.85%vs 37.67%±7.06%,P=0.05).The extend of disease was not of influence.However,variants of ATG16L1(WT:2.03±0.19 vs homozygoot variant:4.38±0.37,P<0.009)as well as NOD2(C-ins)(heterozygous variant:42.08±2.94 vs homozygous variant:75.58±4.34(P=0.05)are associated with the phagocytic activity in patients with CD.CONCLUSION:Monocytes of CD patients show enhanced phagocytosis associated with the presence of ATG16L1 and NOD2 variants.This could be part of the pathophysiological mechanism resulting in the disease. 相似文献
104.
Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient''s distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer. 相似文献
105.
Emily B. Schroeder Kelly R. Moore Spero M. Manson Megan A. Baldwin Glenn K. Goodrich Allen S. Malone Lisa E. Pieper Stanley Xu Meredith P. Fort Linda Son‐Stone David Johnson John F. Steiner 《Journal of clinical hypertension (Greenwich, Conn.)》2020,22(7):1228-1238
Interactive voice response and text message (IVR‐T) technology may improve hypertension control in under‐resourced settings. We conducted a randomized clinical trial to determine whether an IVR‐T intervention would improve blood pressure (BP), medication adherence and visit keeping among adults with hypertension from multiple racial and ethnic groups in primary care at an Urban Indian Health Organization in Albuquerque, New Mexico. Two hundred and ninety‐five participants were randomly assigned to IVR‐T (N = 148) or to usual care (N = 147). The IVR‐T arm received reminders for clinic visits, messages to reschedule missed clinic visits, monthly medication refill reminders, weekly motivational messages, and a blood pressure cuff. The usual care arm received no messages. The primary outcome was change in systolic BP (SBP) between baseline and 12 months. Secondary outcomes included change in SBP between baseline and 6 months, change in diastolic BP (DBP) at 6 and 12 months, self‐reported adherence at 6 months, and the proportion of missed primary care clinic appointments. The intervention did not affect SBP or DBP at 6 or 12 months. The 12‐month change in SBP/DBP was 1.66/1.10 mm Hg in usual care and 0.23/1.34 mm Hg in the intervention group (P values = .57 and .88, respectively). Self‐reported medication adherence improved comparably in both groups, and there was no difference in percentage of kept visits. Several features of study design, clinic operations, and data transfer were barriers to demonstrating effectiveness. 相似文献
106.
If association between the decline in physical performance and the decline in pulmonary function is confirmed, the SPPB could be used as a predictor for pulmonary functional declines in aging people because of its convenient use. This study aimed to elucidate the association of the SPPB with the pulmonary function test (PFT) to determine the usefulness of the SPPB as a predictor of PFT decline. The SPPB and PFT were performed on random sample nested in the Korean Longitudinal Study of Aging (KLoSA) panel, a national representative sample of aging people in Korea. Comparisons of adjusted means of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory ratio (FER) defined as FEV1/FVC between normal and abnormal SPPB groups were performed using the t-test. The association between PFT and SPPB abnormality was examined using multiple logistic regression analysis. Additionally, the associations of gait speed and chair stand time with FEV1 and FVC were examined using multiple linear regression analysis. Five hundred and eighteen subjects were included in analysis. Approximately 43% (222/518) of the subjects were male and 65% (338/518) were 60 years or older. Adjusted means of FEV1 and FER were significantly or marginally lower when SPPB score was abnormal in both overall and non-smoking men (p=0.009 and 0.053 for overall, p<0.001 and p<0.080 for non-smokers), but FVC was lower only in non-smoking men (p=0.024). Abnormal SPPB score was significantly associated with abnormal PFT regardless of sex. (adjusted odds ratio=OR=3.76, 95%CI=1.96-7.22 for men, adjusted OR=2.11, 95%CI 1.28-3.47 for women). Gait speed was significantly or marginally associated with FEV1 and FVC in participants 60 years or older, regardless of sex. We conclude that abnormal SPPB score was associated with abnormal pulmonary function. Thus, the SPPB has the potential to be used as an early predictor of abnormal pulmonary function in clinical settings and epidemiological study. 相似文献
107.
Soo-Byung Park Jong-Kyoon Yoon Yong-Il Kim Dae-Seok Hwang Bong-Hae Cho Woo-Sung Son 《Journal of cranio-maxillo-facial surgery》2012,40(4):e87-e92
BackgroundThe purpose of this study was to evaluate nasal morphologic and maxillary skeletal changes occurring after bimaxillary surgery in skeletal class III patients, using a new method entailing superimposition of cone-beam computed tomography (CBCT) volumes.Materials & methodsThe subjects consisted of 30 adults (15 males and 15 females) who had presented with skeletal class III deformities. The subjects underwent Le Fort I advancement and impaction osteotomy and mandibular setback surgery. For closure of the maxillary vestibular incision, alar cinch suture and V-Y closure were performed. The pre- and post-operative CBCT data were superimposed and evaluated by voxel-by-voxel registration.ResultsAfter surgery, the nasolabial angle, nasal tip angle, nasal tip inclination and columellar angle showed significant increases (P < 0.01). The nasal tip protrusion and nasal height, meanwhile, had significantly decreased (P < 0.01), and the alar base width had increased (P < 0.01). The columellar length and nostril axis angle also had decreased, but the nostril area did not show any significant change.ConclusionsAfter surgery, as the maxilla had been moved upward and forward, the nasal tip was shifted antero-superiorly and the alar base width and nostrils were widened. CBCT superimposition, enabling 3D assessment of nasal morphologic changes, can be an effective tool for simultaneous measurement of skeletal and soft-tissue changes. 相似文献
108.
109.
Lee JI Oh SJ Ha WC Kwon HS Sohn TS Son HS Cha BY 《Diabetes research and clinical practice》2012,95(1):42-47
Aim
To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] and arterial stiffness in patients with type 2 diabetes.Methods
Serum 25(OH)D was measured in a cross-sectional sample of 131 men and 174 women aged 30 years and over in Korea. Arterial stiffness was assessed by pulse wave velocity (PWV) obtained with a VP-2000 pulse wave unit. Fasting plasma glucose, insulin, lipid profile, HbA1c, calcium, phosphorous, and HS-CRP were measured.Results
The prevalence of vitamin D deficiency was high (85.9%). Those with lower vitamin D levels had increased PWV. Using multivariate regression analysis, low 25(OH)D concentrations independently predicted PWV (p < 0.001) in people with type 2 diabetes after adjustment for other risk factors such as age, smoking, hypertension, HS-CRP, diabetes duration, hypertension duration, HbA1c, and BMI.Conclusions
Vitamin D deficiency is common in type 2 diabetes, and a low 25(OH)D level is significantly associated with increased arterial stiffness in these patients. Vitamin D may influence the development of cardiovascular disease. Clinical intervention studies are needed to clarify whether treatment with vitamin D decreases the risk of cardiovascular disease in patients with type 2 diabetes. 相似文献110.
Background/Aims: To evaluate the effects of medical nutrition therapy (MNT) on body composition and metabolic syndrome (MetS) components in premenopausal Korean women with a body mass index ≥23. Methods: Participants (n = 160) were classified into MetS (n = 44) or non-MetS (n = 116) groups based on the criteria proposed by the revised National Cholesterol Education Program-Adult Treatment Panel III and the International Diabetes Federation classification. Anthropometric and dietary assessments and blood analyses were performed for all participants prior to and following 12 weeks of MNT. Results: Following MNT, body fat decreased in both groups by roughly 11% (p < 0.001), and the number of participants meeting the criteria for MetS thus decreased from 44 to 19 (56.8%). Mean waist circumference (WC), blood pressure (BP), plasma triglyceride (TG) and blood glucose levels decreased in the MetS group (p < 0.001). Body fat reduction in the MetS group was correlated with changes in WC (r = 0.584), systolic BP (r = 0.451), diastolic BP (r = 0.429) and plasma TG (r = 0.488) levels after adjusting for covariates (p < 0.05). Conclusions: Body fat reduction and MetS component improvement was achieved by MNT in overweight women. Changes in MetS components appear to be related to body fat reduction. MNT should focus on body fat reduction when used as a primary prevention for MetS. 相似文献