A case of anencephaly associatied with twin pregnancy that delivered by primary lo-wer flap transverse cesarean section at 35-weeks of gestation is presented with brief revi-ew of literatures.
Anencephaly* ; Cesarean Section ; Female ; Humans ; Pregnancy ; Pregnancy, Twin*

The indications of hyperbaric oxygen therapy (HBOT) covered by the health insurance in Korea increased to 16 in 2019, which includes acute central retinal artery obstruction within 24 hours of vision loss; anemia due to excessive bleeding, since blood transfusion is impractical; chronic refractory osteomyelitis (Wagner grade ≥3); and intracranial abscess.Current Concepts: HBOT affects the treatment in the primary and secondary mechanisms. According to the Boyle’s law, the primary mechanism is important in treating decompression sickness and intravascular air embolism by decreasing the volume of air bubbles when pressure increases, whereas the secondary mechanism involves hyperoxygenation of the primary mechanism and various effects, such as vasoconstriction, angiogenesis, immune function enhancement, reperfusion injury prevention, antimicrobial action, and gas washout effect, occur. In the past 5 years, domestic HBOT has made significant progress. However, there are many non-therapeutic lowpressure HBOT facilities that are limited by insurance coverage issues, quality equipment management, and medical personnel in HBOT facilities.Discussion and Conclusion: To solve the problem, the introduction of the definition of therapeutic hyperbaric pressure and certification system of HBOT facilities must be initiated. Moreover, the system should be improved so that insurance can be applied for a more indication of HBOT.

PURPOSE: Overcrowding in urban emergency departments (EDs) while a decline in rural EDs due to mismatch of supply and demand of emergency medical resources are still issues to date. Therefore, this study analyzed the current characteristics and reality of bed utilization in the EDs of Korea. METHODS: Real-time availability of bed information was obtained from the emergency medical resource information system. The data were extracted for 4 weeks every 3 months, from April 2014 to January 2015. We analyzed the emergency department utilization (EDU) rate of emergency medical centers and hospitals based in 16 provinces in Korea. RESULTS: A total of 14,889,750 data were included. The total EDU rate was 20.0% (9.1-43.9%). The EDU rate was 66.7% (40.0-95.0%) for regional emergency medical centers (REMC), 33.3% (15.0-63.3%) for local emergency medical centers (LEMC), 11.1% (0.0-30.0%) for local emergency medical agencies (LEMA). The EDU rate was 71.4.0% (50.0.0-96.7.0%) for tertiary general hospitals (TGH), 20.0% (10.0-36.8%) for general hospitals (GH), and 10.0% (0-20.0%) for hospital & medical centers (HMC). The REMC EDU rate was high in Seoul and Jeonbuk, and low in Jeonnam and Gyeongbuk. The LEMC utilization rate was high in Daegu and Jeonbuk. The LEMA utilization rate was high in Daegu and Ulsan. Moreover, despite the same ED type, the EDU rate of high degree hospitals was higher. CONCLUSION: The EDU rate differed by region, emergency medical center, and hospital type. We should consider investing in appropriate personnel and emergency medical resources in places with suboptimal EDU rate.
Daegu ; Emergencies* ; Emergency Service, Hospital* ; Gyeongsangbuk-do ; Health Resources ; Hospitals, General ; Information Systems ; Jeollabuk-do ; Jeollanam-do ; Korea ; Seoul ; Ulsan

PURPOSE: This study aims to analyse the epidemiologic characteristics of burn in the elderly and to discusses a possible prevention program for this population. METHODS: A retrospective review of all medical records of elderly patients (above 60 years old) admitted with burns to the burn center of the Hanil General Hospital from January 1996 to December 2007 was carried out. Patient demographics, etiology, extent, and type of burn, seasonal variation, and mortality rates were reviewed. RESULTS: A total of 537 elderly patients (mean age of 69.8 years, median age of 68 years, range 60~97 years) was admitted. The gender ratio of the patients was 1:.5 with 217 men and 320 women. The most common causes were scald burn (44.9%) and flame burn (35.4%). The average total body area burned was 13.5% (range 0~95%). Twenty six patients (4.8%) died. CONCLUSION: In elderly patients, scald burns are more common in women but flame burns are more common in men. The mortality rate is higher in flame burns and men
Aged ; Burn Units ; Burns ; Demography ; Female ; Hospitals, General ; Humans ; Male ; Medical Records ; Retrospective Studies ; Seasons

PURPOSE: Compared to urban areas, access to emergency medical services in rural areas is relatively restricted both in quality and quantity. However, based on the aged population model, the need for such services is greater in rural areas, due to accidents and underlying disease. We set out to investigate whether education for emergency medical services would be helpful for utilization of poor resources for emergency medical services in rural areas and how efficient it might be. METHODS: Goheung (n=796) and Haenam (n=819), which appeared to be similar in terms of area, population composition, and quality and quantity of emergency medical services, were selected. While one area received Life Helper for the Village, one of the educational programs for emergency medical services, the other did not. A questionnaire containing items on recognition of emergency medical services and roles of the primary responder was administered. RESULTS: Significant differences were observed in the recognition of emergency medical services and safety awareness in Goheung, to which education for emergency medical services was provided. However, we did not find a relationship between injury or accident development and education for the rural emergency medical service system in two areas. CONCLUSION: Thus, provision of education is needed for development of common residents into primary responders in alienated rural and fishing villages, offering them ongoing and repeating education in order to increase their recognition of emergency medical services and safety awareness, and expand such education to areas that are in a similar situation.
Aged ; Emergencies ; Emergency Medical Services ; Emigrants and Immigrants ; Humans ; Surveys and Questionnaires

Spontaneous urinary bladder rupture is uncommon, but is associated with significant morbidity and mortality because of delayed diagnosis. A 65-year-old man was admitted to the emergency room because of low abdominal pain and abdominal distention of sudden onset. The previous night, he had consumed a bottle of alcohol and fallen asleep. Diagnosed as peritonitis of unknown origin, he was prescribed antibiotics empirically. However, the ascites progressed and oliguric acute renal failure developed. On the fifth day, we measured the creatinine level in the ascitic fluid and performed retrograde cystography. He was diagnosed as idiopathic spontaneous bladder rupture and underwent a primary repair successfully. When a patient presents with acute abdominal pain, ascites, and oliguric acute renal failure without definite causes, physicians should consider idiopathic spontaneous bladder rupture, measure the creatinine level in the ascitic fluid immediately, and perform retrograde cystography to obtain an early diagnosis.
Abdomen, Acute ; Abdominal Pain ; Acute Kidney Injury ; Aged ; Anti-Bacterial Agents ; Ascites ; Ascitic Fluid ; Creatinine ; Delayed Diagnosis ; Drinking ; Early Diagnosis ; Emergencies ; Humans ; Peritonitis ; Rupture ; Rupture, Spontaneous ; Urinary Bladder

The purpose of this study was to investgate and evaluate whether the recording information contained in the work authorization was performed properly and master casts were designed accurately according to the rationale and principles of the removable partial denture when the work authorization and the master casts were sent to the dental framework. the accurate recording of the work authorization sent to dental laboratory in Hwasun for removable partial denture framework, the normal form of the occlusal rest guiding plan of the surveyed crown using the surveyor, the location analysis of the occlusal rest seat, the design patten of the maxillary and mandibulary major connectors, the use of the surveyor on the master cast, the status of the secondary impression taken in the distal extension edentulous areas were investigated for this study. The following results were obtained : 1. In the status of the occlusal rest seat prepared in the abutment, the occlusal rest seat with normal form was 81.25%, 95.45%, that without form was 6.25%, 0.00%, respectively in Class I and Class II on the maxillary cast and the occlusal rest seat with normal form was 76.92%, 95.45%, that without form was 7.69%, 0.00% respectively in Class I and Class II on the mandibular cast. 2. In the status of the guiding plan, the guiding plan with the normal form was 79.17%, 86.36% that with abnormal form was 20.84%, 13.64% respectively in Class I and Class II on the maxillary cast and the guiding plan with normal form was 79.49%, 77.27%, that with abnormal form was 20.51%, 22.73% respectively in Class I and Class II on the mandibular cast. 3. The abutment splinting in the distal extension removable partial denture was 20.78%, 27.27%, respectively in Class I and Class II on the maxillary cast and was 25.64%, 13.64% respectively in Class I and Class II on the mandibular cast. 4. The location and form of the major connector delineated on the maxillary and mandibular master cast was 95.83%, 98.41% respectively. 5. The delineation and recording on the work authorization was incomplete as group II(73.33%), group I(14.07%), group III(12.59%) and group IV (0.00%) in investigating the contents of the work authorization. 6. Aker's clasp of the types of the direct retainer was nots used 72.22%, 74.60%, in the maxillary and mandibular casts respectively. 7. The location of the indirect retainer delineated on the maxillary and mandibular master cast was 51.43%, 50.82% respectively. 8. The types of metal used were mostly Cr-Co non-precious metal alloy and the cases using color coding on the drawing paper of work authorization were not observed. 9. The cases taking secondary impression in the distal extension removable partial denture were 45.71%, 52.46% respectively in the maxillary and mandibular master cast. 10. The delineation of tripoding or reference line on the master cast was not observed in surveying procedure.
Alloys ; Clinical Coding ; Crowns ; Denture, Partial, Removable ; Laboratories, Dental ; Splints

The upper and the lower master models of Class II mod.1 by the Kennedy of classification were duplicated to the dentists in the dental clinic Suncheon, and the status of the surveying procedure, the form and type of the major connector, the form and type of the direct retainer, the location and status of the indirect retainer, and the modification of abutment were surveyed and analyzed and were compared to the principles of the design rationale of the removable partial denture to evaluate whether or not each component of the removable partial denture framework designed by the dentists. The analyzed results were as follows: 1. The status with or without the surveying procedure was showed 7 cases(10.29%) and 61 cases(89.71%) respectively. 2. Single palatal strap, A-P bar, broad palatal plate, complete coverage palatal major connector, single palatal bar, U-shaped palatal connector, and the others without drawing of the major connector were 27 cases (38.57%), 25 cases(35.71%), 5 cases(7.01%), 4 cases(5.71%), 2 cases (2.86%), 1 cases(1.43%), 6 cases(8.57%) respectively in the design patterns of the maxillary major connectors, and lingual bar, linguoplate, and others without drawing of the major connector were 55 cases(80.88%), 11 cases(16.18%), 2 cases(2.84%), respectively in the pattern of the mandibular major connectors. 3. The direct retainer designed to the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area was that the design of bar clasp was 67.41% in the highest rate and that of Akers clasp was 23.36%. 4. The direct retainer designed to the 1st bicuspid of the upper right and the lower left was that the of Akers clasp was 56.62% in the highest rate and that of bar clasp was 33.82%. 5. The mesial rests of the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area were 77.46%, 66.20% respectively and the distal rests and mesial rests of the 1st bicuspid of the upper left and the lower right were 58.82%, 55.71%, 38.24%, 38.57% respectively and the mesial rests of the 2nd molar of the upper right and the lower left were 95.71%, 95.65% respectively, viewed from the location of the occlusal rest seat. 6. The cases without the design of the indirect retainer were 51.47% in the upper and the lower master models respectively. 7. The modification of abutments(surveyed crown) of upper and lower teeth were 8.82%, 8.82% respectively.
Bicuspid ; Dental Clinics ; Dentists ; Denture, Partial, Removable ; Humans ; Leprosy ; Molar ; Tooth

Dental infection which has been harmful to human for a long time occurs when the balance of three factors; host, environment and source of infection are broken and occurs especially when the balance of the resistance of the host and the toxin of bacteria are collapsed. Though dental-origin infection causes severe pain, it is commonly localized in gingiva, pulp and the surface of alveolar bone and as the decrease of its prevalence due to the development of antibiotics and the ease of treatment by a simple aids, there are no case that proper caution are made for the infection. Expecially in case of patient with infectious Hansen's disease(leprosy), as they have many other medical diseases, dental disease are mostly passed by. As oromaxillary infection can end up to death, though it is hard to treat a severly progressed myofascial space infection, general understanding about the reason, the pattern of spreading, treatment, prevention of it should be needed to make actual management in the situation of an doubtless developing of infection in patient treatment and situation of suspicious development of early myofascial space infection. Since last 5 years, 36% of the patients were hospitalized due to their dental infection and consistent advertising and treatment resulted in a gradual decrease of it.
Anti-Bacterial Agents ; Bacteria ; Gingiva ; Humans ; Prevalence ; Stomatognathic Diseases

The purpose of this study was to examine subjective oral health perception of Hansen's disease in Sorokdo. And the relationship of four categories (chewing ability, intraoral pain, intraoral othersysptom, and communication ability and social relationship) with clinical index was tried to clarify. The 460 subjects of Hansen's disease in Sorokdo was selected for oral examination and survey. The results are as follows: 1. 73.1% of Hansen's disease in Sorokdo recognized that their oral health is unwell. 2. 70% of total population recognized that they have limitation about chewing function, Especially, 35.9% of Hansen's disease feels chewing difficulty for standard foodstuffs as rice cake. 3. In intraoral pain, painful tooth was 76.3%, sensitive tooth was 43.2%. and temporomandiblular joint pain was 15.2%. 4. In intraoral other symptoms, tooth mobility was 71.3%, food impaction was 78.9% gingiavl bleeding was 96.8%, xerostomia was 62.8%, and halitosis was 84.2%. 5. 21.5% of Hansen's disease in Sorokdo has communication difficulty by teeth or denture problem, and 39.2% of them avoid relationship with other people.
Aged ; Arthralgia ; Communication ; Dentures ; Diagnosis, Oral ; Halitosis ; Hemorrhage ; Humans ; Leprosy ; Mastication ; Oral Health ; Tooth ; Tooth Mobility ; Xerostomia