Zygomatic arch is a prominent structure among facial bone and this is the major cause of vulnerability from the facial trauma. The fracture of zygomatic arch has been treated by ancillary methods of closed reduction approaching through temporal incision or intraoral incision. But, these methods gas a limitation of reduction force vector and it has a difficulty in maintaining the secure fixation of the reduced unstable fractured bones. All 22 cases of zygomatic fracture were reduced by transcutaneous screw and fixed with external fixation device successfully. There was no post-operative complication, such as non union, malunion, and visible scar. This method also has advantages of less post-operative edema and pain.
Cicatrix ; Edema ; External Fixators ; Facial Bones ; Zygoma* ; Zygomatic Fractures

No abstract available.
Enbucrilate* ; Facial Bones*

Treatment of zygoma fracture with displacement at the multiple ariticulations frequently results in incomplete fracture reduction because of difficulties involved in the application of vector force during the reduction procedure. The vector force in opposite to the vector force of injury may not exert adequately through the skin incisions of open reduction. We treated 46 patients of isolated zygoma fracture with transcutaneous screw pin reduction and external fixation. After insertion of a transcutaneous screw pin through the fractured zygoma segment, the vector force of reduction could be applied easily by tracting screw pin along with the opposite force to the injury vector. The external fixation could easily immobilize the fracture segment for a period from 9 to I4 days. In all patients accept one, we could perform fracture reduction accurately without malunion or any other complication. Aside from the direct application of vector froce in the desired direction, advantages of this method are shorter operation time, no incision scar, and no implantation of internal fixation.
Cicatrix ; Humans ; Skin ; Zygoma*

BACKGROUND: Extended-spectrum beta-lactamase-producing (ESBL) Klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive care units (NICUs). This study aimed to reduce ESBL-producing K. pneumoniae in the NICU by using infection control measures. METHODS: We performed prospective surveillance cultures, monitoring, and education for infection control in the NICU between May and August 2011. Specimens were collected from all infants and the environment including stethoscopes, thermometers, ventilators, incubators, etc. The anterior nares and hands of healthcare workers were also screened. We inspected infection control practices and provided feedback. The level of infection control awareness was measured using a questionnaire. RESULTS: The level of awareness and performance of hand washing increased significantly after intervention (both P<0.001). The environmental management of healthcare providers also improved significantly (P=0.001). The yield of ESBL-producing K. pneumoniae from clinical specimens decreased gradually throughout the study period (30.4% in May to 12.6% in August). Central catheter-related K. pneumoniae bacteremia decreased from 1.3/1000 to 0/1000 catheter-days. CONCLUSION: Infection control measures including education, monitoring, and surveillance can lower the incidence of ESBL-producing K. pneumoniae in the NICU.
Bacteremia ; beta-Lactamases ; Cross Infection ; Delivery of Health Care ; Hand ; Hand Disinfection ; Health Personnel ; Humans ; Incidence ; Incubators ; Infant ; Infant, Newborn ; Infection Control ; Intensive Care Units ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Klebsiella ; Klebsiella pneumoniae ; Pneumonia ; Prospective Studies ; Stethoscopes ; Thermometers ; Ventilators, Mechanical

Medial orbital wall fracture was described by Converse and Smith in the first time in 1957. These fractures which comprise more than 30% of all the orbital wall fracture are may easily be overlooked in routine orbital radiology. Accordingly, examination with orbital CT is essential for accurate diagnosis and appropriate treatment. These type of fracture are followed frequently by post-oprative complication such as diplopia and enophthalmos because it is very difficult to approach to orbital medial was in these operations. The mechanism of the orbital wall fractures are abruptly increased hydraulic pressure by sudden impact on orbital rim or soft tissue of orbital region. So patients who show the signs of subcutaneous emphysema, edema on the orbital region or diplopia need to get through examination with orbital CT for accurate diagnosis and immediate reconstruction of the fractured orbital wall. Conventional approaches in the operations of the orbital medial wall fractures are that with bicoronal incision, subciliary incision, transconjunctival incision and infra-orbital rim incision. But, approach with bicoronary incision, needs broader dissection and longer time for operation. Operations with transconjunctival incision and that with subciliary incision have difficulty to approach to fractured sites. Operations with other conventional methods may be also followed by scar problem. The authors performed reduction and reconstruction of the fractured orbital medial wall fractures successfully without any complications and difficulties by intra-eyebrow approach with which they made incision of 2 - 2.5 cm on mid-area of eyebrow to expose fractured medial wall with good operative field.
Cicatrix ; Diagnosis ; Diplopia ; Edema ; Enophthalmos ; Eyebrows ; Humans ; Orbit* ; Subcutaneous Emphysema

No abstract available.
Bony Callus*

No abstract available.
Fingers* ; Nasal Bone*

No abstract available.
Graves Disease* ; Insulin*

No abstract available.
Hand*

Craniosysostosis is a congenital anomaly which should be corrected at an early age. The correction should be both for shape as well as to assure normal growth of the brain. In the past, many patients of craniosysostosis underwent corrective suturectomy only for the purpose of removing constructive forces on the brain. However, recurrence is frequent and further deformity in the shape of the skull and face often develop. The particular patient in this article had undergone a simple suturectomy in the neurosurgery department. For 12 years, he had suffered from not only the deformed shape of the skull but also from medical refractory epileptic convulsions. Therefore, the patient underwent total cranial remodeling for correction of a deformed forehead and skull following correction of the bone contour. Unexpectedly, the epileptic convulsions of the patient markedly improved with the new shape. Based upon these results, the authors suggest that secondary total cranial remodeling can improve the convulsions by affecting the epileptic focus which may have been caused by previous operational scars on the dura.
Brain ; Cicatrix ; Congenital Abnormalities ; Craniosynostoses* ; Forehead ; Humans ; Neurosurgery ; Recurrence ; Seizures* ; Skull