Gradual distraction on living tissues creates stress that stimulates growth and regeneration. Timing and rate of distraction are one of the major factors affecting callus distraction. Slow rate of distraction often led to premature consolidation of the lengthening bone, while rapid rate of distraction often resulted in undesirable change within lengthening bone. Since Dr. McCarthy reported the successful lengthening of mandible in hemifacial microsomia, most of craniofacial bone lengthening has been done at a rate of 1.0 mm per day. The purpose of this study is to present my experience of rapid and multidirectional distraction of mandible in hemifacial microsomia. I have performed distraction osteogenesis of mandible in 33 patients of hemifacial microsomia with an age of 2-9 years from November, 1995 to October 1997. A complete osteotomy was made at the angle of mandible posterior border of the ramus proximal to the osteotomy and two threaded wires were inserted aling the lower border of the body distal to the osteotomy. Long PennigMinifixator(Orthofix, Bussolengo, Italy) maintained the mandible in fixation for 4 days. Following this period, the device was lingthened serially 1 mm every 12 hours by turning the nut. After the period of active lingthening was complicated, the mandible was maintained in external fixation until the radiological consolidation of the bone was confirmed. According to a study protocol, photographs, cephalograms(lateral and frontal), and panoramic view of mandible were obtained preoperatively, just before the active lengthening, at the time of removal of the device, and at 6 months intervals thereafter. The amount of vertical distraction along the posterior border of the ramus was from 19 to 32 mm and horizontal distraction along the lower border of the body was from 3 to 18 mm. The total amount of distraction was from 25 to 47 mm. The period of rapid distraction was from 13 to 27 days. Following the period of rapid distraction the mandible was maintained in external fixation for an average of 8.5 weeks(ranging from 7 to 11 weeks). There was no preoperative complications, and the length of clinical follow-up tangles from 3 to 26 months. Early reconstruction with minimal morbidity of rapid and multidirectional mandibular distraction in the hemidacial microsomia was successful without relapse. Orthodontic treatment can begin as soon as possible after gradual distraction in order to establish normal dental occlusion.
Bone Lengthening ; Bony Callus ; Dental Occlusion ; Follow-Up Studies ; Goldenhar Syndrome* ; Humans ; Mandible* ; Nuts ; Osteogenesis, Distraction* ; Osteotomy ; Recurrence ; Regeneration

No abstract available.
Epidermolysis Bullosa* ; Hand Deformities* ; Hand*

OBJECTIVE: To define the healthcare information industry in order to propose a developmental direction for the industry, classify and analyze the healthcare information industry business models, and propose strategic guidelines for development of the healthcare information industry. METHODS: A survey was conducted to investigate the private companies that provide healthcare information. For in-depth investigation of the study subjects, they were categorized based on their means of service provision. Open colloquium participation requests were extended to the representative companies, and five open-colloquiums were held. Additional data were obtained through a structured questionnaire investigating the problems and complaints, followed by a discussion on strategies and future plans. RESULTS: Through a review of previous research on internet business model classification, four major model classification systems were chosen and the healthcare information business models were classified. Based on the composite opinions derived from the participating companies, policy guidelines were proposed. CONCLUSION: It is important to cooperate with experts from each field under governmental supervision and help the general public appreciate the value of healthcare information, thereby achieving the industrialization and development of the health information provision business.
Commerce ; Delivery of Health Care ; Internet ; Organization and Administration ; Surveys and Questionnaires ; Industrial Development

OBJECTIVE: The purposes of this research are to survey the consumers' opinions about the health information privacy, to understand the consumers' privacy.protective behaviors out of the concern about the privacy breaches, to know the consumers' recognition about the constitution of the health information privacy law, to know the consumers' willingness to share their personal medical information. METHODS: The questionnaire was developed and conducted by the California HealthCare Foundation on "National Consumer Health Privacy Survey" was translated into Korean and reviewed by the authors to conform to the Korean situation. We collected data from 335 on.line survey responses. RESULTS: Consumers concerned about the privacy of their personal health information. Consumers are unfamiliar with health information privacy law. Consumers think that the paper medical records are more secure than electronic medical records. Not so many Korean consumers practice the privacy.protective behaviors even though they worry about the misuse of the health information. However, consumers will share their personal medical information with limited others such as family members and physicians involved in their care. CONCLUSIONS: Most of the consumers answered that the information could be shared when necessary, however, the ownership and the right to decide the disclosure should belong to patient, and patient should be allowed to access their own information with certain degree of regulation.
California ; Constitution and Bylaws ; Consumer Health Information ; Delivery of Health Care ; Disclosure ; Electronic Health Records ; Humans ; Jurisprudence ; Medical Records ; Ownership ; Privacy* ; Surveys and Questionnaires

Cleft lip and/or palate are the most common congenital malformations in the head and neck region throughout the world. Both genetic and environmental influences were believed to cause cleft lip and palate. This study has been undertaken in order to find the possible relationship between cleft lip and palate and drug use in early pregnancy. The data from 314 mothers of infants who have cleft deformity under 2 years old were analyzed as a case group. And the data from 312 mothers of healthy infants under 2 year old were analyzed as a control group. The data including birth weight of baby, age of mother and drug use in early pregnancy were collected through direct interview using questionnaire. The data were calculated by multivariate analysis to evaluate the possible association between drug use in early pregnancy and the occurrence of cleft deformity. There was no difference between the case and control group regarding to birth weight and the age of mother. And there was positive relations of smoking of mother and indoor smoking of father with the occurrence of cleft palate. Alcohol consumption of mother was also related with the occurrence of cleft lip and cleft lip with palate. The data showed positive relation of the drugs for common cold-including antitussives, antihistamine, NSAID-with the occurrence of cleft lip and cleft lip with palate. There was also positive relation of herb medicine with the occurrence of cleft lip and isolated cleft palate. In the case of multivitamin users, significantly decreasing cleft lip occurrence was showed. The data showed that the exposure of some kinds of drugs in early pregnancy may play some role in the development of cleft deformity. But further studies designed to focus on specific component of suspected drugs and the amount exposed in early pregnancy to reveal the causal relationship are also needed.
Alcohol Drinking ; Antitussive Agents ; Birth Weight ; Case-Control Studies* ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities* ; Fathers ; Head ; Humans ; Infant ; Mothers ; Multivariate Analysis ; Neck ; Palate ; Pregnancy* ; Questionnaires ; Smoke ; Smoking

The goals of this study were to present presurgical naso-alveolar molding (PNAM) appliance in unilateral cleft lip and palate treatment and to evaluate the effects of PNAM appliance on alveolar molding. Samples were consisted of 4 unilateral cleft lip and palate infants (3 males and 1 female, mean age=23.2 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the greater and lesser segment was 8.27 mm and average duration of alveolar molding treatment was 9.7 weeks. These patients' models were obtained at initial visit (TI) and after successful alveolar molding (T2). Seven linear and five angular variables were measured by using photometry and digital caliper. All statistical analyses were performed by SPSS win ver. 7.5 program. Paired t-test was used to compare the mean values. 1. The posterior part of alveolar segments are the stable structures during alveolar molding treatment period in infants. 2. Forward growth of the greater segment may be hindered by the action of alveolar molding. 3. The closure of cleft gap during alveolar molding were usually due to inward and backward bending of the anterior part of the greater segment and outward bending of the whole lesser segment.
Cleft Lip* ; Female ; Fungi* ; Humans ; Infant ; Male ; Orthodontics ; Palate* ; Photometry ; Seoul

OBJECTIVE: This study determines the usability of the experimental u-Healthcare services program by examining the prior experience of COPD patients. METHODS: A qualitative content analysis and in-depth interviews were conducted. A total of eight COPD patients with prior experience in u-Healthcare services were interviewed between August 12, 2009 and September 10, 2009. RESULTS: The participants were asked open questions on u-Healthcare services, including their general experience, major attributes, service expectations, future usage intentions, and education and training needs. The participants were also asked to indicate current healthcare inconveniences that u-Healthcare services might solve. CONCLUSION: The results of this study based on patient experience suggest the potential viability of u-Healthcare services.
Delivery of Health Care ; Humans ; Intention ; Pulmonary Disease, Chronic Obstructive

OBJECTIVES: This study identifies the current status and problems of adverse event reporting system in Korean hospitals. The data obtained from this study will be used to raise international awareness and enable collaborative researches on patient safety. METHODS: We distributed the questionnaire developed by the Agency for Healthcare Research and Quality (AHRQ), USA to the 265 risk managers of hospitals by e-mail. Seventy-two percent of the risk managers responded to the inquiry. RESULTS: Eighty-five percent of the hospitals responded that they collect information regarding the event where harm has occurred or might have occurred to a patient. Seventy-five percent of the hospitals did not allow individuals to report occurrences without identifying themselves. Only 54% of the hospitals had an organized patient safety program that manages or coordinates all of the hospital's patient safety activities. The most frequent reason why errors were not reported was the fear of individuals being involved in the investigation and potential disadvantage resulting from it. Eighty-five percent of the hospitals produced reports of their adverse event data, but 68% of the hospitals did not distribute occurrence reports within the hospital. CONCLUSIONS: Lack of standardized reporting system, available information, procedures for protecting the reporting individuals, and mindlessness/indifference of the hospital employees are identified as the major problems. Therefore, it is crucial to address these problems to develop appropriate solutions, enable proactive involvement from the healthcare community, and change the overall patient safety culture, specifically protecting privacy, to increase the quality of service in the healthcare industry.
Delivery of Health Care ; Electronic Mail ; Health Care Sector ; Health Services Research ; Humans ; Patient Safety ; Privacy ; Surveys and Questionnaires

Secondary bone grafting in the alveolar cleft has proven effective in stabilizing the maxillary segments, providing continuity of the maxillary arch and facilitating the canine eruption into the proper position. The purpose of this study is to longitudinally evaluate the treatment results of secondary iliac bone grafting in 40 alveolar cleft patients with an observation period of more than 12 months. Interdental alveolar cleft height was measured in conventional dental radiographs taken no more than 1 month preoperatively, following the completion of all orthodontic expansion, using ratio of the adjacent tooth root and the narrowest point of cleft height. And then we measured the bone resorption rates in 1, 3, 6, and 12 postoperative months, respectively. There was significant positive correlation between presurgical alveolar cleft height and postoperative bone resorption rate. But there was not significant correlation between presurgical alveolar height and the age at operation. The overall success rate for achieving bony bridge across the cleft was 95%. The maximal bone resorption occured in 1 month after operation. In case that the secondary iliac bone graft was performed at the patient's pre-eruption stage of canine, 89% of the patient's canine erupted in 12 months after operation.
Bone Resorption ; Bone Transplantation* ; Humans ; Tooth Root ; Transplants