PURPOSE: The purpose of this study was to explore the meaning of pregnant women's experiences with drinking alcohol during first trimester of pregnancy METHODS: The data were collected through in-depth interviews of 7 pregnant women who drank alcohol in the first trimester. Giorgi's phenomenological method was used for data analysis. RESULTS: Findings included 6 main themes and 14 themes. The main themes concerning pregnancy and drinking were: ‘Open attitude in drinking, History of drinking in family or spouse, Seeking information in how drinking affects pregnancy, Regret not doing planned pregnancy and not quitting drinking before pregnancy, Willing to stop drinking until the child birth, Awareness about importance of preconception care. CONCLUSION: The results of this study provide a deeper understanding of pregnant women's experiences of drinking alcohol during the first trimester of pregnancy. These results can be used in the development of strategies to prevent drinking alcohol during first trimester and to support preconception care and prenatal care.
Binge Drinking ; Child ; Drinking* ; Family Planning Services ; Female ; Humans ; Methods ; Parturition ; Preconception Care ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Pregnant Women* ; Prenatal Care ; Spouses ; Statistics as Topic

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
Anesthesia, General ; Anesthesia, Local ; Catheters ; Cicatrix ; Diagnosis ; Orbit* ; Orbital Fractures ; Silicones

Objective: Isotretinoin is commonly prescribed worldwide despite its notorious teratogenicity. A risk management program (RMP) was introduced in Korea to prevent isotretinoin use during pregnancy. Here, we evaluate the compliance of Korean women with the recommendations of the RMP. Methods: This prospective cohort study was conducted between April 2019 and June 2020. Thirty-six and 82 patients received the prescription before and after the introduction of RMP, respectively. Results: There was a significant difference in the total number of days for which isotretinoin was prescribed before and after the RMP was introduced (68.8±100.9 and 28.0±26.1 days, respectively). However, 1.43% (120/8,394) of the total patients contacted by the teratology information services were exposed to isotretinoin on an average. Conclusion The proportion of patients exposed to isotretinoin did not change, and there was no significant change in compliance, with the implementation of the RMP during the study period. Further studies are needed to evaluate the effectiveness of the RMP in the long term.

Objective: Isotretinoin is commonly prescribed worldwide despite its notorious teratogenicity. A risk management program (RMP) was introduced in Korea to prevent isotretinoin use during pregnancy. Here, we evaluate the compliance of Korean women with the recommendations of the RMP. Methods: This prospective cohort study was conducted between April 2019 and June 2020. Thirty-six and 82 patients received the prescription before and after the introduction of RMP, respectively. Results: There was a significant difference in the total number of days for which isotretinoin was prescribed before and after the RMP was introduced (68.8±100.9 and 28.0±26.1 days, respectively). However, 1.43% (120/8,394) of the total patients contacted by the teratology information services were exposed to isotretinoin on an average. Conclusion The proportion of patients exposed to isotretinoin did not change, and there was no significant change in compliance, with the implementation of the RMP during the study period. Further studies are needed to evaluate the effectiveness of the RMP in the long term.

No abstract available.
Spine*

No abstract available.
Paraplegia* ; Tuberculosis, Spinal*

BACKGROUND AND PURPOSE: We investigated whether the intracranial arterial calcification status reflects the overall cerebral atherosclerosis burden. METHODS: Patients with acute cerebral infarction who were admitted to a single university hospital stroke center and underwent brain computed tomography angiography (CTA) between May 2011 and December 2015 were included. We reviewed their demographic, clinical, and imaging data. Cerebral artery calcification was assessed from the cavernous portion of both internal carotid arteries, and patients were categorized into three groups according to the calcification status. The cerebral atherosclerosis score was calculated as the sum of the degree of stenosis of the major intracranial and extracranial arteries on brain CTA. RESULTS: In total, 1,161 patients were included (age=67±13 years, mean±standard deviation), of which 517 were female. Intracranial arterial calcification and atherosclerosis were detected in 921 patients. The cerebral atherosclerosis score tended to increase with the calcification status (no calcification=2.0±3.0, mild=3.8±3.8, severe=6.5±4.8; p < 0.001 in analysis of variance followed by the Bonferroni test). Multivariable logistic regression analysis including age, sex, vascular risk factors, body mass index, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and calcification status showed that intracranial calcification was independently associated with an advanced cerebral atherosclerosis burden in a dose-dependent manner (compared to no calcification: odds ratio=2.0 and 95% confidence interval=1.1–3.4 for mild calcification, and odds ratio=4.7 and 95% confidence interval=2.7–8.3 for severe calcification). CONCLUSIONS: This study found that the calcification status of the cavernous portion of an internal carotid artery can reflect the overall cerebral atherosclerosis burden.
Angiography ; Arteries ; Atherosclerosis ; Body Mass Index ; Brain ; C-Reactive Protein ; Carotid Artery, Internal ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Female ; Glomerular Filtration Rate ; Humans ; Intracranial Arteriosclerosis* ; Logistic Models ; Risk Factors ; Stroke ; Vascular Calcification

In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this 8x6 cm defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.
Arm ; Bandages ; Blood Transfusion ; Drainage* ; Estrogens, Conjugated (USP)* ; Female ; Free Tissue Flaps ; Heparin ; Humans ; Hyperemia ; Leeches ; Middle Aged ; Pressure Ulcer ; Salvage Therapy ; Scalp ; Tissue Donors ; Veins ; Wounds and Injuries

Nasoalveolar molding (NAM) device is an effective treatment for protruding maxilla in infants with cleft palate. However, only a few studies have investigated the effect of NAM devices on the treatment of protruding maxilla in infants with cleft lip only. We have designed a combination treatment using NAM devices prior to cheiloplasy for cleft lip-only patients with severe anterior protrusion of the premaxilla. Three cleft lip-only infants with 1-cm or more of premaxilla protrusion were included. Definitive cheiloplasty was performed at 6 months of age without any preoperative correction in infant 1. Cheiloplasty was performed in conjunction with the use of NAM device and lip adhesion in infants 2 and 3. Postoperative columella length and anterior-posterior dimension of the protruding premaxilla were compared amongst the infants. We were able to obtain satisfactory postoperative columella length and general nasal appearance.
Cleft Lip* ; Cleft Palate ; Fungi* ; Humans ; Infant ; Lip* ; Maxilla ; Orthodontic Appliances

BACKGROUND: Mivacurium is a non-depolarizing neuromuscular blocking agent which has short duration of action. The goal of this study was to describe a technique which could shorten the onset time of mivacurium for rapid endotracheal intubation by using priming principle. METHODS: Thirty-one patients were randomly allocated into four groups. Patients in group I(n=8) received a single dose of 0.12 mg/kg mivacurium. Those in group II(n=10), III(n=6), and IV(n=7) received 0.015 mg/kg pancuronium, 0.012 mg/kg vecuronium, and 0.008 mg/kg mivacurium 4 minutes before the intubating dose of 0.12 mg/kg mivacurium was given respectively. Accelerographic response to train-of-four(TOF) stimulation of ulnar nerve at 15 seconds interval was used for neuromuscular monitoring. The onset time, the duration and recovery indices were compared between groups. RESULTS: The onset time in group II (2.9 0.49 min) and III (2.33 0.4 min) were significantly faster than that in group I (5.19 0.47 min). In the group II, the duration (26.3 1.9 min) and recovery index (12.35 2.45 min) were significantly prolonged than those in group I (9.12 1.21 and 4.75 0.52 min), respectively. CONCLUSION: The onset time is more rapid when pancuronium or vecuronium is used as priming agent than when mivacurium as single bolus injection or priming agent.
Humans ; Intubation, Intratracheal* ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Pancuronium* ; Pharmacology ; Ulnar Nerve ; Vecuronium Bromide*