No abstract available.
Bone Transplantation ; Maxilla ; Osteotomy

No abstract available.
Drug Therapy* ; Liver* ; Plasma*

PURPOSE: To evaluate the incidence of disc extrusion and neurologic deficit, the relation between disc extrusion and neurologic deficit and the treatment results according to our basic treatment principles in lower cervical facet joint fracture and dislocations MATERIALS AND METHODS: Twelve patients were evaluated, 8 male and 4 female with an average age of 41 years comprised the group. Six injuries were attributable to automobile accidents, 5 to fall from building, bed, floor and hill, and one to stand on her head. One case was distractive-flexion stage (DFS) 1, 9 cases with DFS 2 and 2 cases with DFS 3. Plain X-ray, CT, Myelo CT and MRI were used as a diagnostic tools. As a treatment criteria, feasibility of closed reduction, status of neuroglogic injury, and stability of injured spine were considered. Anterior cervical discectomy and fusion in accompanied disc extrusion, posterior reduction and fusion with triple wiring in unreduced dislocation, and anterior decompression and fusion in incomplete cord and root injury were selected as a basic treatment principles. RESULTS: Ten out of 12 cases (83%) showed neurologic deficits, 2 complete cord injury, 1 incomplete cord injury, and 7 radiculopathy. Nine out of 12 (75%) demonstrated disc extrusion and all disc extruded patients had neurologic deficits. Anterior cervical discectomy and fusion (ACDF) were performed in 5 cases, ACDF and posterior reduction with triple wiring (PRTW) in 4 cases, PRTW in 1 case, and skull traction and philadelphia brace in 2 cases. Seven radiculpathy patients were completely recovered and one incomplete cord injury patient can ambulate with spastic gait after surgery. There were 2 bed sore and 1 pneumonia in complications. CONCLUSION: Soft disc extrusion should be evaluated carefully with MRI and CT in lower cervical spine injury with the facet joint fracture-dislocations before the decision of treatment. As disc extrusion always accompanies neurologic deficit, it must be surgically treated by anterior cervical discectomy and fusion.
Automobiles ; Braces ; Decompression ; Diskectomy ; Dislocations* ; Female ; Gait Disorders, Neurologic ; Head ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pneumonia ; Pressure Ulcer ; Radiculopathy ; Skull ; Spine ; Traction ; Zygapophyseal Joint*

Dysarthric patients often present velopharyngeal incompetence (VPI), characterized nasalization articulation for hypernasality,which seriously impaired their communication. Research of evaluation of VPI is mainly about cleft palate and postoperative, few about the dysarthria. Some approaches, such as physiologic approach to rehabilitation, have been used to correct hypernasality, and prosthesis,such as palatal lift prosthesis (PLP) and nasal speaking valve (NSV), are also proved effectively. PLP has been widely used for hypernasality oversea, but fewer in China.

Objective To investigate the vowel's nasalance and contact quotient (CQ) in children with hearing loss. Methods 57 subjects were divided to 3 groups: profound hearing loss children with hearing aids (HA, n=19), profound hearing loss children with cochlear implant (CI, n=19) and children without hearing loss (n=19). With the help of NV and electroglottography (EGG), the subjects' nasalance and CQ were recorded when they said /a/, /æ/, /i/, /o/, /u/. Results There was no significant differences among the 3 groups on nasalance (P>0.05). There was significant difference among 5 vowels on nasalance, ranked as /u/, /o/, /æ/, /i/, and /a/ (P<0.001). There was significant difference among 3 groups on CQ, ranked as HA, normal, and CI group (P<0.001). There was significant difference on CQ among 5 vowels,ranked as /i/, /u/, /æ/, /o/, and /a/ (P<0.001). Conclusion The voice and resonance should be assessed before speech therapy, which the speech therapy starts from the most correct vowel for children with profound hearing loss.

No abstract available.
Thanatophoric Dysplasia*

No abstract available.

PURPOSE: The present study was designed to understand the conceptual definition and attributes of the clinical critical thinking ability(CCTA) in nursing and to grasp the characteristics of clinical critical thinking abilities. METHODS: The data were analyzed using the Hybrid model of Schwartz-Barcott and Kim(2000). RESULTS: Having the skills and dispositions to think critically, CCTA refers to something that implies the cognizant ability to interpret contextual meanings, analyze the relationships between materials or circumstances, draw out the best conclusions, predict things using relevant information and evaluate the reliability of information and the strength of inference on the one hand and the emphatic disposition to be curious, open-minded, intellectually integral, systematic and creative and to reflect on things in contextual terms on the other. CONCLUSION: CCTA is characterized by clinical circumstances, such as guessing the reasons for facts, predicting things, connecting theory to practice and approaching individual situation in total terms as well as by the Korean circumstances, such as taking another person's perspective. Hence, this study proposes developing the tools to measure the clinical critical thinking ability and the strategies to improve the clinical critical thinking ability and seeking to verify their validity, on the basis of the findings.
Chimera ; Clinical Competence ; Concept Formation ; Hand ; Hand Strength ; Problem Solving ; Thinking

PURPOSE: Asymptomatic urinary retention in the post-partum period is a relatively common problem. We investigated prospectively the incidence and the various risk factors associated with asymptomatic urinary retention in post-partum. MATERIALS AND METHODS: From Feb. 1999 to Apr. 1999, all pregnant women who visited our hospital for delivery were evaluated. Among them 103 women who had undergone vaginal delivery were evaluated, Exclusion criteria were cesarean section, incidental catheter indwelling during delivery, and symptomatic urinary retention. Residual urine volume was measured using BladderScanTM BVI 2500(Diagnostic Ultrasound co.) within 10 minutes after first voiding in immediate post-partum period. Asymptomatic urinary retention was defined as residual urine volume over 150ml. Pre-partal urinary symptoms and various obstetric parameters were evaluated in asymptomatic urinary retention group and normal group as control. Asymptomatic urinary retention group were followed up daily to monitor their post-void residual urine volume. RESULTS: The incidence of asymptomatic urinary retention after vaginal delivery was 13.6%. Factors associated with asymptomatic urinary retention included second stage of labor, episiotomy, and instrumental delivery. There was no relationship between pre-partal lower urinary tract symptoms and post-partal asymptomatic urinary retention. In patients with asymptomatic urinary retention, catheterization was done for removing residual urine and thus preventing progression of further distension. Post-void residual volume was normalized within 3 days in all patients. CONCLUSIONS: Asymptomatic post-partum urinary retention is a self-limiting phenomenon associated with various traumatic events during hard labor such as prolonged labor, episiotomy, instrumental delivery. Close observation of voiding patterns in patients with risk factors is needed to prevent myogenic failure associated with unrecognized asymptomatic post-partum urinary retention.
Catheterization ; Catheters ; Cesarean Section ; Episiotomy ; Female ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Pregnancy ; Pregnant Women ; Prospective Studies* ; Residual Volume ; Risk Factors ; Ultrasonography ; Urinary Retention*

The most important basic requirements for successful skin grafting are the accurate approximation of the edge of the skin graft to that of the wound and the application of even pressure to the graft by a carefully designed dressing. Pressure dressing is indicated for the protection of the graft and the prevention of shearing between the graft and its bed. One of the most widely used methods of pressure dressing is tie-over dressing. The traditional technique is based on the application of long silk sutures along the margin of the graft that are tied over bolus of antibiotics oint-impregnated nonadherent fluffed gauze. With the traditional tie-over dressing, it is impossible to inspect the graft bed for possible hematoma and seroma during the application of dressing. So we adopted another modification of the previously described tie-over dressing methods. From January 1997 to July 1997, we had performed 27 skin graft surgeries and 8 subdermal shavings in 35 patients with our new method of tie-over dressing. We can apply even pressure to the grafts by twisting the long silk sutures instead of typing.In comparison with the plethora of devices and techniques described previously in tie-over dressing construction, our technique offers simplicity and reliable fixation of the graft to the bed and allows further adjustment of the dressing by individual tightening of the threads. Other particularly attractive features are the ability to inspect the graft at any time with little difficulty and the reapplicability of tie-over dressing with the remaining long threads if needed.
Anti-Bacterial Agents ; Bandages* ; Hematoma ; Humans ; Seroma ; Silk ; Skin ; Skin Transplantation ; Sutures ; Transplants ; Wounds and Injuries