We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-orthodontic treatment. The other case. Bone grafting was done after removal of prosthesis with no pre-orthodontic treatment. 2. After mucoperiosteal incision in cleft area, the mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiograph and prosthetic treatment of missing teeth were done.
Bone Transplantation* ; Humans ; Incisor ; Nasal Mucosa ; Nose ; Oroantral Fistula ; Palate ; Prostheses and Implants ; Recurrence ; Tooth ; Transplants

BACKGROUND: Surveillance of surgical site infection is a main component of nosocomial infection surveillance. To perform a valid comparison of rates among hospitals, among surgeons, across time, surgical site infection rates must account for the variation in patient's underlying severity of illness and other important risk factors. So, a risk index was developed to predict a surgical patient's risk of acquiring a surgical site infection. The risk index score, ranging from 0 to 3, was the number of risk factors present among the following: (1) a patient with an American Society of Anesthesiologists preoperative assessment score of 3,4,5, (2) an operation classified as contaminated or dirty-infected, and (3) an operation lasting over T hours, where T depends upon the operative procedure being performed. METHOD: We performed surgical site infection surveillance according to patient risk index after cardiovascular surgery from Mar 1, 1997 to May 31, 1997. In addition, we also monitored nosocomial infection of all patients after cardiovascular surgery Data was collected prospectively, Surgical site infection rate was classified according to patient risk index and compared with NNIS (National Nosocomial Infections Surveillance) semiannual report of 1995. RESULT: Overall nosocomial infection rate was 18.9% and among all patients detected by surveillance protocols, pneumonia was the most common (6.3%) nosocomial infection after cardiovascular surgery, and the remaining infections were distributed as follows: surgical site infection 45%, urinary tract infection 3.2%, bloodstream infection 3.2%. Surgical site infection rate for patient with scores of 0, 1, 2 and 3 were 0%, 3.1%, 4.6%, 66,7%, respectively and increased according to patient risk index (P<0.05). There is no statistical difference between our surgical site infection rate and 1995 NNIS semiannual report of surgical site infection rates (P>0.05). CONCLUSION: The patient risk index is a better predictor d surgical site infection risk than the traditional wound classification system and surgical site infection surveillance with patient risk index is useful for nosocomial infection surveillance after surgery.
Classification ; Cross Infection ; Humans ; Operative Time ; Pneumonia ; Prospective Studies ; Risk Factors ; Surgical Procedures, Operative ; Urinary Tract Infections ; Wounds and Injuries

PURPOSE: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. METHODS: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. RESULTS: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. CONCLUSION: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.
Child ; Counseling ; Financial Support ; Hospices ; Hospitalization ; Humans ; Information Centers ; Information Services ; Internet ; Mass Media ; Quality of Life ; Spouses ; Telephone

The diaphragm is especially important in sustaining minute ventilation in the neonate. Consequently, diaphragmatic paralysis is not tolerated well by the neonate and often results in prolonged respiratory failure. We experienced a case of unilateral diaphragmatic paralysis with the brachial plexus palsy in a male newborn infant who presented with apnea and cyanosis due to birth asphyxia. After endotracheal intubation, mechanical ventilaton was started. At two weeks after therapy, chest X-ray showed atelectasis and elevation of the right hemidiaphragm. The diagnosis of unilateral diaphragmatic paralysis was confirmed by real-time ultrasonography. At 4 weeks old, after several unsuccessful attempts at weaning from ventilatory support, right hemidiaphragm was plicated. On the second postoperative day, he could be weaned from ventiatory support without difficulty. He was doing well at follow-up 3 months later.
Apnea ; Asphyxia ; Brachial Plexus* ; Cyanosis ; Diagnosis ; Diaphragm ; Follow-Up Studies ; Humans ; Infant, Newborn* ; Intubation, Intratracheal ; Male ; Paralysis* ; Parturition ; Pulmonary Atelectasis ; Respiratory Insufficiency ; Respiratory Paralysis* ; Thorax ; Ultrasonography ; Ventilation ; Weaning

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with evidence of immune activation and is associated with extraintestinal diseases in numerous target tissues. Extraintestinal manifestations of UC are well described in numerous tissues, most notably mucotaneous, synovial, biliary, and opthalmic. Among hematological complications of UC, autoimmune hemolytic anemia is often reported, but immune-mediated thrombocytopenia (ITP) is rare. We present one case in which exacerbation of UC sequentially induced development of ITP. Platelet-associated antibodies were positive. Bone marrow examinations revealed increased megakaryocyte number. ITP was treated with corticosteroids, intravenous immune gamma- globulin and plasmapheresis. However, because previous treatments were not successful, splenectomy was done. This may provide further evidence that ITP is causally associated with UC, and is the result of immunostimulation from luminal antigens and altered immunoregulation.
Adrenal Cortex Hormones ; Anemia, Hemolytic, Autoimmune ; Antibodies ; Bone Marrow Examination ; Colitis, Ulcerative* ; Humans ; Immunization ; Inflammatory Bowel Diseases ; Megakaryocytes ; Phenobarbital ; Plasmapheresis ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy ; Thrombocytopenia ; Ulcer*

Heterotopic pregnancy in a natural cycle is rare case. This case occurs by one out of 30,000 cases of pregnancies. It is quite difficult to diagnose a heterotopic pregnancy clinically. But, recently, the availability of high-resolution sonography has improved the preoperative diagnosis rate. We present a case of spontaneous heterotopic pregnancy which was diagnosed pre-operatively by transvaginal ultrasound.
Diagnosis* ; Pregnancy ; Pregnancy, Heterotopic* ; Ultrasonography*

The Ael subgroup expresses the least amount of A antigens and could only be detected by performing the adsorption-elution test. The frequency of the Ael subgroup is about 0.001% in Koreans, and the Ael02 allele, which originates from A102, is the most frequently identified allele in the Korean population. We report a Korean family with the Ael03 allele identified by molecular genetic analysis. To the best of our knowledge, this is the first such report in Korea to date.
ABO Blood-Group System/*genetics ; Alleles ; Base Sequence ; DNA Mutational Analysis ; Exons ; Frameshift Mutation ; Humans ; Male ; Middle Aged ; Pedigree ; Phenotype ; Polymerase Chain Reaction ; Republic of Korea

PURPOSE: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. METHOD: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. RESULTS: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. CONCLUSION: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.
Antineoplastic Combined Chemotherapy Protocols ; Clinical Protocols ; Cytarabine ; Etoposide ; Eye ; Humans ; Intensive Care Units ; Methotrexate

BACKGROUND: Anthrax is a zoonotic disease caused by Bacillus anthracis, a gram-positive, spore- forming bacillus. Several cases of anthrax have been reported in Korea; it occurred as an outbreak after ingesting raw meat of an anthrax-infected cow. Among those reported cases, most of them were of gastrointestinal anthrax and a case report of cutaneous anthrax was also included. An outbreak of anthrax occurred in a village of Chang-Nyeong, Kyoungsangnamdo, Korea on July, 2000. The source of infection was the meat of an infected cow. We investigated clinical features and epidemiologic characteristics of the outbreak. METHODS: Subjects were inhabitants and visitors who were exposed to the contaminated meat by ingestion or handling. Diagnosis and classification of clinical forms of anthrax were done according to the CDC case definition. A group of investigators composed of epidemiologists and medical doctors visited the village, and examined the residents and visitors exposed to contaminated meat by interviewing with standard questionare and physical examination. RESULTS: Among 40 persons who contacted meat by ingestion and/or handling, 5(12.5%) developed cutaneous anthrax and 2 of them died; 4 were confirmed cases and 1 was suspected case. B. anthracis was isolated from the vesicular lesions of hands or forearms in those 4 confirmed cases and, in one patient who died of meningitis, the organism was also isolated in blood culture. All patients were of cutaneous anthrax, 3 were recovered and 2 died due to complications : one of meningitis and the other of intracranial hemorrhage. All 40 people consumed meat in cooked state not in raw. No anthrax occurred in 28 persons who only ingested cooked meat without any contact with the raw meat. Five cases of cutaneous anthrax were developed among those 12 persons who handled raw meat in preparation for cooking. CONCLUSION: Anthrax should be suspected in patients with cutaneous lesions of vesicle or eschar on their exposed area after contacting animals or animal products, especially in an outbreak.
Animals ; Anthrax* ; Bacillus ; Bacillus anthracis ; Centers for Disease Control and Prevention (U.S.) ; Classification ; Cooking ; Diagnosis ; Eating ; Forearm ; Gyeongsangnam-do* ; Hand ; Humans ; Intracranial Hemorrhages ; Korea* ; Meat ; Meningitis ; Physical Examination ; Research Personnel ; Zoonoses

BACKGROUND/AIMS: Cytomegalovirus (CMV) reactivations are frequently observed in patients with active ulcerative colitis (UC), and ganciclovir therapy is effective in patients with steroid-refractory UC. This study aimed to determine the long-term outcomes of CMV reactivation and the long-term therapeutic efficacy of ganciclovir treatment. METHODS: This retrospective multicenter study included a cohort of 72 patients with moderate-to-severe UC who were evaluated for CMV reactivation at the time of their initial UC flare. Colectomy, disease relapse, and the recurrence rate of CMV reactivation were investigated. RESULTS: The mean duration of follow-up for the 72 patients was 43.16+/-19.78 months (range, 1 to 67 months). The cumulative colectomy (log-rank, p=0.025) and disease flare-up rates (log-rank, p=0.048) were significantly higher in the CMV-positive group. Of the 11 patients who were successfully treated with ganciclovir in the initial treatment, three patients (27.3%) experienced CMV reactivation, and six patients (54.5%) experienced poor outcomes, such as the need for colectomy or a steroid-dependent state. CONCLUSIONS: The patients who had CMV-reactivated UC showed poor outcomes at the long-term follow-up, and the long-term efficacy of ganciclovir therapy was marginal. Careful assessment is necessary for patients who exhibit evidence of CMV reactivation.
Antiviral Agents/*therapeutic use ; Case-Control Studies ; Cohort Studies ; Colectomy/utilization ; Colitis, Ulcerative/complications/*drug therapy ; *Cytomegalovirus ; Cytomegalovirus Infections/complications/*drug therapy ; Ganciclovir/*therapeutic use ; Humans ; Longitudinal Studies ; Remission Induction ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome ; *Virus Activation