PURPOSE: The purpose of this study were to develop a new restraint for the intensive care units (ICU) and to investigate the application effect in comparison with a control group using existing restraints. METHOD: A non-equivalent control group non-synchronized quasi-experimental research design was used. The participants were 40 (control 20, experimental 20) patients who were recruited by convenience sampling the ICU of a university hospital. To avoid contamination of the experiment, data for the control group were collected prior to the experimental group. Measurement variables were edema and skin damage (redness and abrasion) at the application site, and nurses' perceived convenience in applying restraints. RESULTS: Three days after applying the restraint, amount of edema at the application site was small and incidence of skin damage decreased in the experimental group in comparison with the control group. Also, score for application convenience measured by the nurses was higher in for the newly developed restraint than for existing restraints. CONCLUSION: Results indicate that the newly developed restraint has lower effects such as edema and skin damage and is more convenient compared with existing restraints, and is therefore recommended for patients in the ICU.
Edema ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Research Design ; Restraint, Physical ; Skin

We experienced a case of fetal supraventricular tachycardia (SVT) with fetal ascites diagnosed at 29 weeks of gestation in 29 year-old primigravida woman. Transplacental fetal therapy with maternal oral antiarrhythmic agent (verapamil, diltiazem) resulted in restoration of normal fetal sinus rhythm and disappearance of fetal ascites. At birth, the infant did not show any cardiac arrhythmia and hydropic appearance.
Adult ; Arrhythmias, Cardiac ; Ascites* ; Diltiazem ; Female ; Fetal Therapies ; Humans ; Hydrops Fetalis ; Infant ; Parturition ; Pregnancy ; Tachycardia, Supraventricular* ; Verapamil

OBJECTIVE: To investigate the life of persons with C4 tetraplegia in the community residence. METHOD: This study was designed as a personal interview survey using the questionnaires for the general characteristics, Craig Handicap Assessment and Reporting Technique (CHART), Diener's satisfaction with life scale, and Rosenberg self esteem scale. The subjects were 15 persons with C4 tetraplegia. RESULTS: Among 15 persons, six were married, three of them were married after the injury. Five persons reported being employed, thirteen persons used computers. The number of cases for remodeling their houses were 13. Twelve persons reported being 'glad to be alive'. Their Diener's satisfactionof life scale was 16.6 (slightly dissatisfied). Rosenberg self esteem scale was 23.3. The CHART showed the following scores: physical independence 46, mobility 56, occupation 30, social integration 89, and economic self sufficiency 68. Diener's satisfaction with life scale of the subjects were significantly correlated with that of their caregiver (p=0.006). CONCLUSION: The life of the individual with C4 tetraplegia in the community was more active than expected, considering their substantial physical limitation. Therefore, appropriate post-discharge planning should be included in inpatient rehabilitation program for the C4 tetraplegics.
Caregivers ; Humans ; Inpatients ; Occupations ; Quadriplegia* ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation ; Self Concept

Hip subluxation and dislocation are common orthopaedic problems in children with cerebral palsy. Selective posterior rhizotomy(SPR) is a neurologic procedure aimed in reducing spasticity. Several recent studies have indicated a decrease in spasticity and functional improvement after SPR, and also decrease the tendency toward hip subluxation in children with cerebral palsy. This is a retrospective study to examine whether SPR halts hip subluxation. Between May 1994 and July 1996, 22 children below age of 5 underwent SPR. Twenty children were spastic diplegic types and 2 were mixed type and quadriplegic type respectively. Approximately 50-80% of L2-Sl level dorsal roots was cut, and 13 children had 50% of both Ll roots cut. Migration percentage score (MP) was used to determine progression of hip subluxation during the follow up period (12 36 mos.; Average 15 mos.). Of the total 44 hips in 22 patients, 45.5% (20 hips) improved, 34% (15 hips) remained unchanged, and 20.5% (9 hips) were worsened after SPR. Radiographic stability was achieved in 79.5%. Ll root cut rate (Ll SPR) was 55.5% for improved hips, 67% for unchanged hips, and 50% for worsened hips. Two patients had undergone orthopaedic procedure for progressive hip migration. Most patients experienced postoperative hip stability after SPR, but 20.5% were worsened and 2 patients had orthopaedic procedure. Also it is unlikely that Ll root involvement prevents progression of hip migration.
Cerebral Palsy* ; Child ; Dislocations ; Follow-Up Studies ; Hip* ; Humans ; Muscle Spasticity ; Retrospective Studies ; Rhizotomy* ; Spinal Nerve Roots

PURPOSE: The purpose of this study was to assess the usefulness of multiplanar reconstruction (MPR) images in the preoperative evaluation of advanced gastric cancer. METHODS: Multidetector-row CT (MDCT) was performed on 61 patients with advanced gastric cancer, and the coronal and sagittal multiplanar images reconstructed from the transaxial data. The combined axial and MPR images were compared to the axial images alone to determine if the image quality and diagnostic accuracy had been improved. RESULTS: The observed image quality of the combined axial and MPR images, graded relative to the axial image alone, was fair in 22 (36.1%), good in 27 (44.2%), and excellent in 12 cases (19.7%). For the T staging, the diagnostic accuracy of combining the axial and MPR images (75.4%) was higher than that of the axial image alone (70.7%). However, there was no significant difference in the accuracies between the two methods (McNeamar test, P>0.05). For specific regions, the diagnostic accuracies of combining the axial and MPR images and the axial image alone were as follows: 90.2, and 73.8% with antral lesser curvature involvement; 93.4, and 75.4% with antral greater curvature involvement; 83.6, and 73.8% with gastric angle involvement; 96.7, and 88.5% with liver left lobe invasion; 90.2, and 83.6% with pancreas head invasion and 96.7, and 85.2% with colon or mesocolon invasion, respectively. CONCLUSION: Combining the axial and MPR images does not improve the depiction of the T staging compared to the axial image alone in advanced gastric cancer. However, combining the axial and MPR images improved the imaging quality and diagnostic accuracy of specific regions where the delineation of the conventional axial image was insufficient. Therefore, combining the axial and MPR images may be very useful in the preoperative evaluation of advanced gastric cancers.
Colon ; Head ; Humans ; Liver ; Mesocolon ; Pancreas ; Stomach Neoplasms*

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine thefactors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenousfistula(AVF). MATERIALS AND METHODS: Forty-nine cases of insufficient hemodialytic AVF were treated in 44patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis wasperformed with urokinase, and was followed by PTA. The initial success rate and complications of PTA wereevaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient 's age, and the duration of renal failure, patency rateswere compared within each subgroup using the Kaplan-Meier logrank test. RESULTS: The initial success rate of PTAfor insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12months. The initial success rate of thrombolysis was 89%(25/28). The complication rate of PTA was 12%(6/49), ofwhich five cases were vein rupture, and one was subcutaneous hematoma. Statistically, the patency rates in theabove mentioned subgroups were not significantly different. CONCLUSION: PTA with or without thrombolysis offerssafe and effective management of insufficient hemodialytic AVF.
Angioplasty* ; Arteriovenous Fistula* ; Constriction, Pathologic ; Hematoma ; Humans ; Renal Dialysis* ; Renal Insufficiency ; Rupture ; Thrombosis ; Transplants ; Urokinase-Type Plasminogen Activator ; Veins

PURPOSE: The purpose of this study is to investigate the factors that predict using mechanical ventilation for patients with organophosphate intoxication. METHODS: We retrospectively reviewed the medical records of 111 patients with acute organophosphate intoxication and who were treated in our emergency center from January 2000 to December 2008. We compared the toxicologic characteristics, the laboratory findings and the APACHE II scores between the Mechanical Ventilation group (MV group) and the non-Mechanical Ventilation group (the non MV group). RESULTS: Sixty three patients were in the MV group and 48 patients were in the non MV group. In the MV group, the patients had an older age (p<0.001), a larger amount of ingestion (p<0.001), a lower initial serum cholinesterase level (p=0.003), a higher APACHE II score (p<0.001) and they ingested a more toxic agent (p=0.001). There were no significant differences in gender, the type of visit and the arrival time between the MV group and the non MV group. CONCLUSION: We suggest that the patient's age, the amount of organophosphate ingestion, the toxicity of the agent, the initial serum cholinesterase level and the APACHE II score are important factors to determine if mechanical ventilation will be applied for patients with organophosphate intoxication.
APACHE ; Cholinesterases ; Eating ; Emergencies ; Humans ; Medical Records ; Respiration, Artificial ; Retrospective Studies ; Ventilation

BACKGROUND: The purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ). METHODS: A total of 15 joints from 11 elderly patients (71-78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated. RESULTS: No patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period. CONCLUSION: Although nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.
Aged* ; Follow-Up Studies ; Humans ; Joints ; Mouth ; Temporomandibular Joint

Endoscopic retrograde biliary drainage (ERBD) is useful for the palliative decompression of biliary obstruction. However, the complications of ERBD include cholangitis, hemorrhage, acute pancreatitis, obstruction of the stent, and duodenal perforation. Pressure necrosis on the duodenal mucosa by the stent may contribute to perforation. Although duodenal perforation following ERBD is very rare compared to other complications, it can result in a fatal outcome. Recent reports describe nonsurgical treatment for small gastrointestinal perforation with localized peritonitis and suggest that endoclipping may be appropriate in the management of a well selected group of patients with iatrogenic perforation. We describe a case of duodenal perforation secondary to ERBD that was successfully treated with approximating using endoclip and detachable snare.
Bile Ducts, Extrahepatic ; Biliary Tract Diseases/complications/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Duodenal Diseases/*diagnosis/etiology/therapy ; Female ; Gallbladder Neoplasms/diagnosis ; Humans ; Intestinal Perforation/*diagnosis/etiology/therapy ; Middle Aged ; Plastics ; Stents/*adverse effects ; Tomography, X-Ray Computed

Skeletal remains collected from the archaeological fields must be maintained carefully, for being used in scientific studies on the physical characteristics, health status, and pathological disease of the ancient or medieval human populations. Even if Joseon Dynasty Human Sample Collection might be a good example for such studies, few of bone collections predated the Joseon Age (e.g. Goryeo Dynasty) have been established until now, possibly owing to poor preservation condition of archaeological sites in Korea. In this study, we performed anthropological studies on a few cases of Goryeo skeletons, which have been rarely reported by anthropologists in Korea. Judging from the preservation status of bones found in various types of Goryeo graves (e.g. earthen- or stone-chambered tombs), many cases seem to be cremated in accordance with Buddhist funeral rites. Goryeo bone collections must be constructed with the bones identified in the earthen tombs, which were preserved much perfectly than those of any other types of Goryeo tombs.
Anthropology, Physical ; Archaeology ; Funeral Rites ; Humans ; Korea ; Skeleton