No abstract available.
Sturge-Weber Syndrome*

No abstract available.
Aneurysm* ; Aorta*

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Therefore, proper treatment method should be applied in order to achive aesthetic and funtioning hand. To reconstruction of soft tissue defect in hand, a variety of treatment have been, but most are associated with drawbacks, such as limited range, limited application, long time surgery, 2nd stage surgery, large donor defect. The reverse dorsal digital and metacarpal island flaps use the dorsal skin of the digital or metacarpal areas, and they are based on the arterial branches anastomosing the volar and dorsal arterial networks. The series of 15 cases of reconstruction for soft tissue defect due to electrical burn in hand were reviewed. Most cases survived completely and we could gain satisfactory results. Advantages of these flaps are minimal defect in donor site, good reliability, short time and easy technique, versatile variation, usefulness in secondary reconstruction. In conclusion, our result suggested that the reverse dorsal digital and metacarpal artery island flap are very useful methods for reconstruction of soft tissue defect due to electrical burn in hand, functionally and aetheticallly.
Arteries* ; Burns* ; Hand* ; Humans ; Skin ; Surgical Flaps ; Tissue Donors

Split-thickness skin graft is a frequent, necessary method of treatment in burn patients. After harvesting a split thickness skin graft, there is a variety of options in the post-operative management of the donor site created. Dressing materials provide an occlusive and wet environment and aids in superior wound healing. Of the commercially available dressing materials, Medifoam(R), Allevin(R) and Polymem(R) are the most commonly used materials during the early phases of epithelization. Medifoam-B(R) is a more absorbant dressing material compared to other dressing materials. Its swelling ratio is 1200% and it contains a layer of wound promoters and antibiotics. The purpose of this study is to compare medifoam-B(R), Allevyn(R) and Polymem(R) in the healing time, infection rate, absorption ratio and pain degree. This study is based on 30 patient who underwent split-thickness skin graft in Hanil General Hospital from March 2002 to July 2002. All skin grafts were harvested with an electric dermatome, with a thickness depth of 0.012 to 0.016 inches. Three divisions of each donor site was managed separately with each different materials through postoperative days 0 to 1. Absorption property, infection rate, pain degree, time to complete epithelization were assessed. Medifoam-B(R) performed superior to Allevyn(R), Polymem(R). In conclusion, We suggest Medifoam-B(R) as a useful alternative in the management of the split-thickness donor site wound in the early phases.
Absorption ; Anti-Bacterial Agents ; Bandages* ; Burns ; Hospitals, General ; Humans ; Skin ; Tissue Donors* ; Transplants ; Wound Healing ; Wounds and Injuries

Objectives: This study aims to identify the factors affecting unmet dental care needs in pregnant women in Korea, and analyze the results. Methods: The study used original data from the 2019 Community Health Survey. A total of 1,146 women who were pregnant at the time were selected as the final subjects for analysis. Complex sample logistic regression analysis was conducted to understand the factors contributing to unmet dental care needs. Results: Among the subjects, 16.3% reported experiencing unmet dental care needs. The main reasons were a lack of time, other reason (pregnancy, bother to go) and minor symptoms. This study found that age and marital status as predisposing factors, number of household members as enabling factors, and subjective oral health status, chewing difficulties, tooth brushing frequency, and subjective stress levels as need factors significantly impacted the experience of unmet dental care needs. Conclusions Customized oral health education for pregnant women is crucial to raise awareness about its significance. Considering that pregnant women may be single-person households or face challenges in visiting the dentist alone, it is necessary to establish a medical delivery system that facilitates access to medical treatment. Furthermore, policy efforts should be directed toward reducing unmet dental care needs among pregnant women.

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the canal encroachment of fractured bony fragments and neurological deficits of pedicle screw instrumentation for the treatment of unstable thoracolumbar burst fractures with pedicle screws inserted into the fractured vertebrae. MATERIALS AND METHODS: The authors evaluated 18 patients treated surgically with posterior fusions using pedicle screws for unstable thoracolumbar burst fractures, from March 2000 to September 2004. The ratios of the areas occupied by the fractured bony fragments in the canals were analyzed, before and after pedicle screw insertion, by computed tomography scans of the fractured vertebrae. The kyphotic angles, anterior vertebral heights, and neurological deficits were evaluated. RESULTS: The areas occupied by the fractured fragments in the canals were improved significantly after surgery and there were no neurological complications resulting from the placement of pedicle screws or fragment displacements. The kyphotic angles and anterior vertebral heights at the last follow-up visits were improved significantly compared with the preoperative radiographs. The neurological deficits were not aggravated after pedicle screw insertion. CONCLUSION: Our results suggest that pedicle screw instrumentation in fractured vertebrae is safe and effective for the treatment of unstable thoracolumbar burst fractures.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spine*

BACKGROUND AND OBJECTIVES: An occult primary tumor is defined as histologic evidence of malignancy in the cervical lymph nodes with no apparent primary site of origin for the metastatic tumor. MATERIALS AND METHODS: Twenty-three patients who have failed to detect primary tumor on their initial physical examinations, endoscopy and other imaging studies, underwent endoscopy-guided biopsy under the general anesthesia. The histologic examination of frozen sections was done in the operation room. For those failing to give results by the histologic study, we performed the ipsilateral tonsillectomy biopsy. RESULTS: Nine primary lesions were identified: four cases of tonsillar fossa, one case each of nasopharynx, base of tongue, hypopharynx, supraglottis, and esophagus. In the three of the four tonsillar cancer cases, the primary foci were also identified by tonsillectomy biopsy. All the patients whose primary foci were tonsillar fossa showed metastasis of the jugulodigastric lymph node. CONCLUSION: Our results indicate that patients who are considered to have occult primary tumor should be evaluated by endoscopy-guided biopsy under the general anesthesia. Also, this study finds that if the histologic result of the frozen section were negative, ipsilateral tonsillectomy can be justified, especially for patients who show metastasis of jugulodigastric cervical lymph node.
Anesthesia, General ; Biopsy* ; Endoscopy ; Esophagus ; Frozen Sections ; Humans ; Hypopharynx ; Lymph Nodes ; Nasopharynx ; Neoplasm Metastasis ; Physical Examination ; Tongue ; Tonsillar Neoplasms ; Tonsillectomy*

BACKGROUND AND OBJECTIVES: Tracheotomy, although an inevitable procedure in some situations, is often avoided in pediatrics for its frequent and serious complications. So, authors studied clinical characteristics of tracheotomy as observed in pediatrics. MATERIALS AND METHODS: 138 children who underwent tracheotomy during the past twenty years since 1977 were investigated. We analyzed distribution of age and gender, annual frequency, causative disorders for tracheotomy and complications. RESULTS: 1) Number of tracheotomy performed tended to be decreased with time: 2) Tracheotomy was performed two times more frequently in males than in females, and most frequently below eight years old: 3) Most frequent causative disease was head injury (27.5%): 4) Most frequent indication of tracheotomy was ventilator support (49.3%): 5) The history of endotracheal intubation before tracheotomy was 86.2%: 6) The complications of the tracheotomy developed in 39.9%, with the most frequent complications being granulation formation (18.1%), followed by tracheal stenosis (17.4%). 7) Frequency of late complication was relatively lower in the shorter intubation period group (22.9%) than in the longer intubation period groups (51.5% and 33.3%): 8) Late complications were lower in the group who had not been supported by a ventilator: 9) Late comlications did not occurre in cases who were decannulated before 1 month. CONCLUSION: We found that factors associated with complications were duration of endotracheal intubation before tracheotomy, history of ventilator care and timing of decannulation.
Child ; Craniocerebral Trauma ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Male ; Pediatrics* ; Tracheal Stenosis ; Tracheotomy* ; Ventilators, Mechanical