Cranocsynostosis is the term that designates premature fusion of one or more sutures in either the cranial vault or cranial base. Especially scaphocephaly, brachycephaly and trigonocephaly are included in simple symmetric craniosynostosis. In simple symmetric craniosynostosis, the functional deformity is rare, but deformity in external appearance is always a serious problem. The purpose of forehead reshaping in simple symmetric craniosynostosis is recovery of normal cerebral growth and improvement of cranial cosmetic problem by restoration of normal calvarial anatomic structure. Various surgical methods have Bbeen developed in an effort to correct craniosynostosis. Cranial vault remodeling with or without supraorbital band advancement is a widely accpeted method of correcting simple symmetric craniosynostosis. However, the standardized surgical method has not yet been estabilished in reshaping the forehead during cranial vault remodeling of simple symmetric craniosynostosis. The authors developed a new osteotomy method, the bull's osteotomy, which is a limited osteotomy for cranial vault remodeling. It produces posterior tilting of a prominant forehead as well as increased biparietotemporal distance for effective forehead reshaping. We applied this techriaue in 8 scaphocephaly and 2 brachycephaly patients under 5 years of age who have not yet reached bony consolidation. All patinets obtained satisfactory results with properly corrected deformity and no relapse was observed during the follow-up period. This new osteotomy method is simple and effective and a consistant surgical outcome is expected. particularly the contour of the forehead on the frontotemporal area is corrected to have a smooth and natural curvature. Based on our experience using bull's osteotomy, we offer this new surgical technique for managing simple symmetric cranoisynostosis patients.
Congenital Abnormalities ; Craniosynostoses* ; Follow-Up Studies ; Forehead* ; Humans ; Osteotomy* ; Recurrence ; Skull Base ; Sutures

No abstract available.
Biofeedback, Psychology* ; Electric Stimulation* ; Pelvic Floor* ; Urinary Incontinence*

No abstract available.
Osteoma, Osteoid* ; Spine*

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

No abstract available.
Dementia* ; Humans ; Urinary Incontinence*

PURPOSE: The purpose of this study was to explore the life experiences of patients with a severe Chronic Obstructive Pulmonary Disease (COPD). METHODS: The data were collected through in-depth interviews of six patients suffering from severe COPD. The interviewed data were audio-recorded and transcribed verbatim and checked for accuracy. The Giorgi method of phenomenology was used for analyzing data. RESULTS: Eight themes forming the, units of meaning, were: Repeated and Unpredictable Suffering of Dyspnea, Confidence Loss/Exhaustion Life due to non-efficient breathing, Gradually Deprived Liberty, Absolute Being to Sustaining my life, Source of Burden but Significant Person I am in the Family, Endless Tug-of-War-Capability/Endeavor to Breath, Longing for my Life, and Dead-end of breathing. CONCLUSION: The study results provide an in-depth understanding of life experiences of patients suffering from severe COPD. The findings will be useful to nurses caring for this population.
Dyspnea ; Freedom ; Humans ; Ice ; Life Change Events ; Pulmonary Disease, Chronic Obstructive ; Respiration ; Stress, Psychological

Systemic lupus erythematosus, an autoimmune disease with multisystem involvement, has been reported to be associated with a number of gastrointestinal complications and symptoms such as nausea, vomiting, and abdominal pain. However, acute pancreatitis only rarely has been reported as a complication of SLE. We report a case of SLE presenting drug unrelated acute pancreatitis as a initial manifestation.
Abdominal Pain ; Autoimmune Diseases ; Lupus Erythematosus, Systemic* ; Nausea ; Pancreatitis* ; Vomiting

Reconstruction of the nasal alar may be challenging due to the complex nature of multiple cosmetic units and functional considerations, including maintenance of valvular competency. Reconstructive options include various flaps or graft repairs, depending on the subunit involvement and the size of the defect. Linear closures may be suitable for small defects, while bilobed flaps, melolabial flaps, and forehead flaps may be considered for moderate to large defects involving partial and full-thickness defects of the ala.
Congenital Abnormalities* ; Forehead ; Transplants