BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

No abstract available.
Aneurysm* ; Renal Artery*

PURPOSE: This study was conducted to develop and evaluate the Psychological Adaptation Improvement Program (PAIP) for international marriage migrant women in South Korea. METHODS: A total of 43 international marriage migrant women who were enrolled in six rural multicultural family support centers in South Korea were included in this study. They were randomly assigned to the intervention group (n = 21) or to the control group (n = 22). The intervention group received 10 sessions of PAIP, 1 or 2 sessions per week for 8 weeks. The dependent variables were self-esteem, depression and social problem solving ability. The data were analyzed by Fisher's exact test, t test, and repeated measures analysis of variance using SAS program. RESULTS: PAIP was effective in increasing self-esteem and reducing depression, and partially showed significant positive effects on participants' social problem solving ability, suggesting increased levels of positive problem orientation and decreased avoidance style in the social problem solving ability subscales. CONCLUSION: PAIP might be used as an effective intervention to improve psychological adaptation among international marriage migrant women in the rural community of South Korea.
Adaptation, Psychological* ; Depression ; Emigrants and Immigrants ; Female ; Humans ; Korea ; Marriage* ; Problem Solving ; Rural Population ; Self Concept ; Social Problems ; Transients and Migrants*

In an open reduction of the mandibular angle fracture, it is crucial to approximate each fracture segment as closer as possible for the reduction of the healing period. In this case report, we proposed a new technique for the mandibular angle fracture. This was designed to minimize the gap between two separated segments using mini-implants and surgical wires. Mini-implants were placed around the fracture line, followed by wire ligation to minimize the fracture gap. And then internal fixation was easily employed with plates and screws. The advantages of this technique were reduced time for operation, the promotion of healing, rapid functional recovery, and few complications.
Ligation

To analyse the age of onset, etiologic microorganisms, clinical manifestations, managements and genetic variation of chromic granulomatous disease, the authors reviewed four patients who were diagnosed as CGD at Department of Pediatrics, Seoul National Univesity Children's Hospital. They were siblings in relationship-two of them were brothers, the others were brother-sister. @ES The results were as follows; 1) Initial manifestations developed within 1 year old, and lymphadenopathy associated with BCG vaccination was the most common. 2) In culture study of micro-organism, catalase positive microorganisms such as Staphylococcus aureus, Serratia marcescens, Coagulase (-) Staphylococcus, Enterococcus, Proleus vulgaris, Klebsiella pneumoniae, E. coli and fungus such as Candida albicans were isolated. In 2 cases, culture study revealed no growth. 3) Fever, lymphadenopathy, hepatomegaly, suppurative dermatitis and pneumonia were the most common manifestations. In most of cases, antituberculous medications were administered under the impression of tuberculosis without response. 4) Immunologic screening tests including B-cell system, T-cell system, and complement system were within normal limit except NBT test. 5) In spite of severe infections, NBT scores of all the cases were less than those of controls. Liver biopsies of 3 cases showed granuloma formation with characteristic yellow brown pigment-laden macrophages.
Age of Onset ; B-Lymphocytes ; Biopsy ; Candida albicans ; Catalase ; Coagulase ; Complement System Proteins ; Dermatitis ; Enterococcus ; Fever ; Fungi ; Genetic Variation ; Granuloma ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Lymphatic Diseases ; Macrophages ; Mass Screening ; Mycobacterium bovis ; Pediatrics ; Pneumonia ; Seoul ; Serratia marcescens ; Siblings ; Staphylococcus ; Staphylococcus aureus ; T-Lymphocytes ; Tuberculosis ; Vaccination

The highly accurate laser holographic interferemotry method was used to determine in what way low-magnitude forces during maxillary expansion are transmitted to the entire maxillary complex and its surrounding structures. The experiments were carried out on a dryed human skull which had a perfectly preserved, normally aligned maxillary dental arch and intact alveolar process. The skull was fixed within a constructed metal frame which ensured maximal stability of the object. The optical equipment and the object were mounted on antivibration table. Interferograms were taken on the lateral and frontal sides of the maxillary complex, using the 10mW He-Ne laser and the double-exposure method. Analysis of the fringe pattern on the recorded object surface was performed by graphically determining the deformation curves related to the bony surface in selected horizontal and vertical planes. On the basis of this study, the following conclusions can be drawn 1. The density of the interference fringes was gradually increased with the degree of expansion force. 2. Mechanical reactions on the maxillary complex, circummaxillary sutures, and surrounding bones were clearly visible, even with the lowest loading degree. 3. The amount of bone displacement was greater in application of the force after 90degrees turn than in initial application of the same force. 4. The direction of interference fringes on the bony surface was similar at all loading degrees.
Alveolar Process ; Dental Arch ; Humans ; Palatal Expansion Technique* ; Skeleton* ; Skull ; Sutures

No abstract available.
Autografts* ; Cartilage* ; Transplantation, Autologous*

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalls in image interpretation related to evaluation of the LCLC. MR arthrogram of 56 shoulders in 41 asymptomatic young, active, male volunteers were prospectively reviewed to evaluate the labral shapes, capsular insertions and images which may mimic the lesions of glenohumeral instability. The anterior and posterior parts of the labra, respectively, varied in shape: triangular (72%,36%), round (13%,35%), cleaved (8%,1%), notched (2%,0%), flat (5%,24%), and absent (0%,4%). The anterior and posterior capsular insertions, respectively, varied in site: Mosely and Oevergaard type I (82%,62%), type II (13%,36%), and type III (5%2%). A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum (29%) and middle glenohumoral ligament in proximity to anterior labrum (5%) simulated a labral tear. Joint fluid interposed in the central, superior portion of the sublabral sulci (25%) simulated a SLAP lesion. Synovial fold (38%) in the axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral-capsular-ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.
Arthrography* ; Cartilage, Articular ; Humans ; Joints ; Ligaments ; Male ; Prospective Studies ; Shoulder ; Volunteers

No abstract available.
Ear Cartilage ; Ectropion ; Eyelids ; Transplants