Bone-anchored auricular prosthesis have been proved that was another apporach to the treatment of the defective external ear. A 19years old woman with hemifacial microsomia was treated with osseointegrated implants for the support of craniofacial prosthesis. 3 implants were placed in temporal region and craniofacial prosthesis was retained with telescopic magnet retention system. The literatures and surgical technique are reviewed and our experience is presented.
Ear, External* ; Female ; Goldenhar Syndrome ; Humans ; Prostheses and Implants*

OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

Purpose: This study evaluated fitness levels of 47 athletes from the 2020 Korean National Prospective Badminton Team by gender and game type (singles or doubles). Methods: Our physical fitness evaluation items included height and weight measurements, grip strength test, back strength test, 20-meter shuttle run test, side step test, standing long jump test, sit and reach test, back extension test, and standing on one leg with eyes closed test. Results: Male singles players weighed significantly less than doubles players (p=0.002). However, there was no difference in height between both group. Male doubles players had significantly higher grip strength (right, p=0.006; left, p=0.002), back strength (p=0.007), and side step results (p=0.029) than did singles players, but male singles players performed significantly better on the 20-meter shuttle run (p＜0.01). Male singles and doubles players did not differ significantly with respect to the results of the standing long jump, sit and reach, back extension, and standing one leg with eyes closed tests (p＞0.05). Female singles and doubles players showed no significant difference in any physical fitness evaluation items (p＞0.05). Conclusion Male doubles players were heavier than male singles players but showed superior strength and agility. Male singles players showed higher cardiopulmonary endurance levels compared with male doubles players. Female singles and doubles players showed no difference between all physical fitness characteristics. Further studies can use our methods of evaluating fitness in badminton players to provide coaches and players with quantitative indicators for optimal game type classification (singles or doubles) and help to devise winning game strategies.

Agar ; Bacteria ; Bacterial Load ; Chlorhexidine ; Mouth ; Povidone-Iodine ; Saliva ; Sheep ; Stem Cells

OBJECTIVE: We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. METHODS: Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. RESULTS: Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. CONCLUSION: Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.
Aneurysm ; Angioplasty, Balloon ; Female ; Fibrinolytic Agents ; Humans ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Platelet Aggregation Inhibitors ; Prognosis ; Retrospective Studies ; Stents ; Stroke ; Thromboembolism ; Thrombosis

The purpose of this study was to evaluate the effect of single antiplatelet treatment on delayed bleeding, in patients undergoing dental extraction. A total of 154 teeth were extracted in 94 patients with ongoing antiplatelet treatment, who were taking single antiplatelet of either aspirin or clopidogrel. All patients underwent simple dental extraction; local hemostasis was performed with gauze-biting, suturing, and/or application of a local hemostatic agent. Delayed bleeding was recorded in 5 teeth out of a total of 154 teeth after extraction, the incidence of postoperative delayed bleeding being 3.2%. The bleeding was controlled by the patients themselves, through application of pressure with additional gauze-biting. No one visited the doctor or emergency room for hemostasis. These results confirmed that patients taking single antiplatelet drugs may have teeth extracted safely without interruption of the antiplatelet treatment.
Aspirin ; Emergency Service, Hospital ; Hemorrhage* ; Hemostasis ; Humans ; Incidence ; Platelet Aggregation Inhibitors ; Tooth

The purpose of this study was to compare the effect of different methods of hand washing by counting the number of bacteria on the hand surface. Eighteen clinicians were chosen and divided into three groups, consisting of six clinicians each. Culturing of the right raw palms of all individuals was performed. Individuals in the control group washed hands for 5 seconds with antimicrobial soap. Group 1 washed their hands for 10 seconds with antimicrobial soap. Group 2 washed with an instant alcohol-based hand sanitizer. After the respective washes, re-culturing of the right raw palm was done for each member of all groups. The colony-forming units (CFU) were calculated at each time point, and the reduction rate of CFU among the three groups were statistically evaluated using student t-test. All groups showed a significant decrease in CFU, according to the time applied (P<0.01). In addition, the reduction rate of CFU between the groups were statistically evaluated with ANOVA (P<0.01). It showed statistically difference between the control group and group 1, control group and group 2. The present study confirmed that the hand washing method with antimicrobial soap for 10 seconds and hand sanitizer, including alcohol, were excellent for decreasing the number of bacteria on the hand surface.
Bacteria ; Bacterial Load* ; Hand Disinfection* ; Hand* ; Humans ; Methods* ; Soaps ; Stem Cells

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

OBJECTIVE: To evaluate the role of lumbar drainage in the prevention of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by coil embolization in good-grade patients. METHODS: One-hundred-thirty consecutive patients with aneurysmal subarachnoid hemorrhage in good-grade patients (Hunt & Hess grades I-III), who were treated by coil embolization between August 2004 and April 2010 were retrospectively evaluated. Poor-grade patients (Hunt & Hess grades IV and V), a history of head trauma preceding the development of headache, negative angiograms, primary subarachnoid hemorrhage (SAH), and loss to follow-up were excluded from the study. We assessed the effects on lumbar drainage on the risk of shunt-dependent hydrocephalus related to coil embolization in patients with ruptured intracranial aneurysms. RESULTS: One-hundred-twenty-six patients (96.9%) did not develop shunt-dependent hydrocephalus. The 2 patients (1.5%) who developed acute hydrocephalus treated with temporary external ventricular drainage did not require permanent shunt diversion. Overall, 4 patients (3.1%) required permanent shunt diversion; acute hydrocephalus developed in 2 patients (50%). There was no morbidity or mortality amongst the patients who underwent a permanent shunt procedure. CONCLUSION: Coil embolization of ruptured intracranial aneurysms may be associated with a lower risk for developing shunt-dependent hydrocephalus, possibly by active management of lumbar drainage, which may reflect less damage for cisternal anatomy than surgical clipping. Coil embolization might have an effect the long-term outcome and decision-making for ruptured intracranial aneurysms.
Aneurysm ; Craniocerebral Trauma ; Drainage ; Follow-Up Studies ; Headache ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Retrospective Studies ; Subarachnoid Hemorrhage ; Surgical Instruments

Neurocutaneous melanosis associated with Dandy-Walker malformation is a rare dysmorphogenesis that is associated with single or multiple giant pigmented cutaneous nevi and diffuse involvement of the central nervous system. In this article, we present a 2-month-old patient with neurocutaneous melanosis associated with Dandy-Walker malformation. In addition, we reviewed the literature and discussed the pathogenesis based on the preferred hypotheses.
Central Nervous System ; Dandy-Walker Syndrome ; Humans ; Hydrocephalus ; Infant ; Melanosis ; Neurocutaneous Syndromes ; Nevus