BACKGROUND AND OBJECTIVES: There are many factors affecting the satisfactory results of nasal bone fracture, such as age, sex, severity of nasal bone fracture and the time from the onset of injury to the beginning of treatment etc. The aim of this study is to evaluate the predictable factors of satisfaction for nasal bone fracture treatment. MATERIALS AND METHODS: The authors retrospectively reviewed the medical records of 85 patients with nasal bone fracture to examine and analyze according to sex and age distribution, cause of injury and the time from the onset of injury to the beginning of treatment. RESULT: In this study, age, sex and severity of nasal bone fracture were found to be unrelated to the satisfactory result. The time from the onset of injury to the beginning of treatment is statistically related to the satisfactory result of nasal bone fracture (p<0.05). CONCLUSION: Early intervention of nasal bone fracture is necessary to obtain satisfactory results.
Age Distribution ; Early Intervention (Education) ; Humans ; Medical Records ; Nasal Bone ; Retrospective Studies ; Treatment Outcome

Cardiovascular diseases are the major threat to human health and underlie almost half of all deaths in China. Even more serious, obesity and cardiometabolic risk factors have emerged to be prevalent in children and adolescents of some affluent regions. As scientific knowledge emerges on the role of nutritional factors and exposures to environmental risk factors in the developmental origins of health and disease, evidence suggests that it is imperative to create and implement early effective prevention strategies, including optimisation of nutrition at first 1 000 days in life course and reduction of risk factors of obesity exposures during whole childhood, to suppress the rising trend of cardiovascular disease, otherwise, the future costs of diagnosis and treatment are likely to be unaffordable.
Adolescent ; Cardiovascular Diseases ; prevention & control ; Child ; China ; Early Medical Intervention ; Humans ; Pediatric Obesity ; epidemiology ; Risk Factors

Autism spectrum disorder (ASD) is a neurodevelopmental disorder typically identified in early toddlerhood. Both retrospective and prospective follow up studies of high risk infants reveal early risk signs of ASD at 12-24 months of age. The most frequently replicated early signs of ASD are atypical visual tracking and coordination, lack of social reciprocity, abnormal social communication and unusual patterns of manipulating objects, atypical sensory exploration, expressed as uncoordinated eye contact, unresponsiveness to naming, lack of social smile, delayed development of nonverbal communication and joint attention, less sharing interest, and unusually repetitive use of objects. Early intervention, before 2 years of age, appears to change the underlying developmental trajectories of the brain in individuals with ASD. In this review, the early risk signs of ASD in infancy and toddlerhood, along with early intervention and their implications, are discussed.
Autistic Disorder* ; Brain ; Child ; Autism Spectrum Disorder* ; Early Intervention (Education) ; Early Medical Intervention ; Follow-Up Studies ; Humans ; Infant ; Joints ; Nonverbal Communication ; Prodromal Symptoms ; Prospective Studies ; Retrospective Studies

BACKGROUND AND OBJECTIVES: An early invasive strategy with coronary angiography and revascularization is currently the recommended treatment for patients at high risk with an acute non-ST-segment elevation myocardial infarction (NSTEMI). In this early invasive strategy, percutaneous coronary intervention (PCI) is generally recommended within 48 hours, but there is little data on earlier intervention in intermediate risk patients. SUBJECTS AND METHODS: We studied retrospectively the past medical records of 118 patients at intermediate risk that were admitted at Pusan National University Hospital and were stratified by the time interval from chest pain onset to PCI (Group I: <24 hr; Group II: 24-48 h; Group III: >48 h). Clinical outcomes were evaluated in terms of in-hospital and 12 months follow-up of a major adverse cardiac event (MACE). RESULTS: Baseline characteristics were not different statistically among the three groups, except for the use of tirofiban. There were no in-hospital deaths or myocardial infarctions (MI) in Group I and Group II patients, but there were three cases of in-hospital deaths in Group III patients. The incidence of a 12-month MACE was 0% in Group I patients, 6.7% (one revascularization) in Group II patients and 17.1% (3 deaths, 3 MIs, 7 revascularizations) in Group III patients (p=0.043). CONCLUSION: In acute NSTEMI, the incidence of a 12-month MACE was lower in the intermediate risk group when PCI was performed in the early period. Early PCI could be recommended in acute NSTEMI on the basis of the status of individual patients.
Angioplasty, Balloon, Coronary ; Chest Pain ; Coronary Angiography ; Early Intervention (Education) ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Prognosis ; Retrospective Studies ; Tyrosine

OBJECTIVES: Dealing with mental diseases is an overriding concern which could bring about improvement in mental health, social equity, and quality of life. This paper analyzes the current state of research infrastructure of national mental health research in Korea and other developed countries and suggests activation plans for psychiatric research. METHODS: After performance of comparative analysis, shortcomings of Korean infrastructure are examined and activation plans are suggested. RESULTS: Korea is comparatively and absolutely lagging behind in terms of mental health Research and Development (R&D), owing to the small investment in R&D, inadequate government-led long-term developmental strategy and supporting system, absence of industrialization of developed techniques and government-led R&D project, and insufficient human resources, which impedes facilitation of mental health research. Thus, in order to facilitate mental health research, 1) Reinforce international cooperation and research capability through cultivation of professionals equipped with international competitiveness. 2) Construct a government-led R&D system by establishment of a comprehensive R&D system and mental health research institutes. 3) Build cooperative systems between industry and academic circles and promote translational research and its practical use in order to lay the cornerstone for industrialization. CONCLUSION: Developed countries have achieved significant growth and superb investment performance in the mental health industry due to constant and active investment by government. In addition, basic-clinical-mental health research regarding early diagnosis, early intervention, and tailored treatment, is actively being put into practice. In Korea, government-led long-term investment plans in psychiatric research and researcher cultivation programs should be implemented. In addition, infrastructure for application of developed techniques should also be established. If so, it will provide momentum for growth and facilitation of psychiatric research.
Academies and Institutes ; Developed Countries ; Early Diagnosis ; Early Intervention (Education) ; Humans ; International Cooperation ; Investments ; Korea ; Mental Health ; Quality of Life ; Translational Medical Research

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

OBJECTIVES: Due to the complex anatomy and function of the head and neck region, the reconstruction of ablative defects in this area is challenging. In addition, an increasing interest in improving the quality of life of patients and achieving good functional results has highlighted the importance of free flaps. The aim of this study was to summarize the results of free flap reconstruction and salvage of free flaps in a single institute, and to analyze differences in the results by the flap donor site, recipient site, and learning curve. METHODS: The medical records of patients who underwent free flap reconstruction from 2004-2012 were reviewed retrospectively. One hundred and fifty free flaps were used in 134 patients, who had an average age of 57.7 years. The types of flaps applied, primary defect sites, success rates, results of salvage operations for compromised flap, and the learning curve were analyzed. RESULTS: The anterolateral thigh flap was preferred for the reconstruction of head and neck defects. The overall success rate was 90.7%, with 14 cases of failure. A total of 19 salvage operations (12.7%) for compromised flap were performed, and 12 flaps (63.2%) were salvaged successfully. Dependency on the facial vessels as recipient vessels was statistically different when oral and oropharyngeal defects were compared to hypopharyngeal and laryngeal defects. The learning curve for microvascular surgery showed decrease in the failure rate after 50 cases. CONCLUSION: The free flap technique is safe but involves a significant learning period and requires careful postoperative monitoring of the patient. Early intervention is important for the salvage of free flaps and for lowering the failure rate.
Early Intervention (Education) ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Head* ; Humans ; Learning ; Learning Curve ; Medical Records ; Neck* ; Quality of Life ; Reoperation ; Retrospective Studies ; Thigh ; Tissue Donors

Cerebral palsy (CP), known as "Little's disease" is the most common neurologic disorder in pediatric patients. The core problem of CP is the abnormal movement and posture which manifests very early in the development. The cornerstone to treat the children with CP is the conventional rehabilitation program based on neurodevelopmental approach that has been done for decades. Recently, various translational research has emerged, and focused on the changing therapeutic paradigm using high technologic equipment such as computer- or robotic-approach, botulinum toxin, or stem cell use with potential therapeutic effect. Many other trials using newly developed devices, or combination of old and new therapies are ongoing to demonstrate the evidence, however obstacles still remain. Regarding rehabilitative therapy, the use of exercise-based treatment such as early intervention, gross motor task training, hippotherapy, reactive balance training, treadmill training with/without body weight support, and trunk-targeted training are promising. Virtual reality, robot-assisted and computer-enhanced therapies are very potent therapeutic tools for CP under way of mass commercialization. Regarding medical therapy, botulinum toxin injection showed the most concrete benefit for CP children. Stem cell therapy is just beginning, performing experimental studies in vivo. The author reviewed the current research, expanding therapeutic options to improve the posture and movement control in children with CP.
Body Weight ; Botulinum Toxins ; Cerebral Palsy* ; Child ; Dyskinesias ; Early Intervention (Education) ; Equine-Assisted Therapy ; Humans ; Nervous System Diseases ; Posture ; Rehabilitation ; Stem Cells ; Translational Medical Research

To settle the controversy over the optimum management strategy for patients with poor-grade(Hunt-Hess grade IV and V) aneurysmal subarachnoid hemorrhage, the medical records of 50 patients admitted in poor Hunt-Hess grade have been examined retrospectively with literature review. Twelve patients underwent early surgery for aneurysmal neck clipping, and for the other patients, initial conservative management was done followed by delayed operation for 19 patients who showed stabilization or improvement of neurologic status. All patients were managed by active treatment(hypertensive, hypervolemic and hemodilutional therapy) after aneurysmal neck clipping. Initial findings such as better neurological condition(Hunt-Hess grade IV) and presence of intracerebral hemorrhage were indicators of good prognosis. Patients with intraventricular hemorrhage and uncontrollably increased intracranial pressure(>40 cm H20 after extraventricular drainage) resulted in severe morbidity or mortality. Regarding the timing of surgery, early intervention led to a better outcome with less morbidity(8% vs. 26%) compared with delaying operation, because of the lower incidence of rebleeding, reduced vasospasm and more effective management of delayed ischemia after surgery. The incidence of intraoperative premature rupture and mortality were not significantly influenced by the timing of surgery. It is concluded that, for poor-grade aneurysm patients without a definite evidence of irreversibility such as brainstem failure signs or uncontrollably increased intracranial pressure, early surgery followed by aggressive treatment to prevent cerebral vasospasm is the treatment of choice.
Aneurysm ; Brain Stem ; Cerebral Hemorrhage ; Early Intervention (Education) ; Hemorrhage ; Humans ; Incidence ; Intracranial Pressure ; Ischemia ; Medical Records ; Mortality ; Neck ; Prognosis ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial

PURPOSE: This study was to investigate the clinical manifestations of FTT in children. METHODS: From March 1997 to July 1999, clinical observations were made on patients with FTT who had visited to Samsung Medical Center. Detailed histories and through physical examinations were taken, and when suspected organic FTT, basic laboratory studies were done. RESULTS: Upon the review of medical records, we investigated the clinical manifestations of 74 children, aged 1 month and 13 year 1 month. The causes of FTT were composed of either physiologic (47.8%) or pathologic (52.2%) ones. Among the physiologic FTT, were there familial short stature (FSS, 14.5%), intrauterine growth retardation (IUGR, 14.5%), constitutional growth delay (CGD, 11.6%), idiosyncrasy and prematurity. Among pathologic causes, neurologic disorders (20%) are the most common causes of FTT, and then follow by GI (13.4%), allergic and infectious disorders in decreasing order. The data showed that average caloric intake in patients with FTT was 76.2% of recommended amount. FTT patients with CGD, IUGR, and idiosyncrasy had tendency to take small foods. The FTT children with prematurity, IUGR and pathologic FTT, were short and thin for their ages. However FTT children with CGD and FSS had tendency to be thin with relatively normal heights for their ages, in comparison with those of the children with prematurity, IUGR and pathologic FTT. CONCLUSION: The diagnosis of FTT was easily obtained with simple and through medical history, physical examination, and minimal laboratory tests. In this study, organic FTT was more prevalent than physiologic one. This results indicate that early intervention is mandatory, because children may develop significant long-term sequelae from nutritional deficiency.
Child* ; Diagnosis ; Early Intervention (Education) ; Energy Intake ; Failure to Thrive* ; Fetal Growth Retardation ; Humans ; Malnutrition ; Medical Records ; Nervous System Diseases ; Physical Examination