Twenty-eight patients with 20 tibia fractures and 8 femur fractures were treated with external fixation. The average age at fracture was 10 years 10 months ranging from 5 years to 17 years 6 months. Of 28 fractures, 6 were closed fractures and 22 were open fractures. The average follow-up of these children was 23 months. Monofixators were used in 12 fractures and Ilizarov fixators in 16 fractures. The average time to healing of the fractures was 14.6 weeks(range, 6 to 44 weeks). Seven segmental bone defects(range, 2 to 17cm) were treated with the Ilizarov method of internal bone transport using the transport ring and bone grafting at the docking site. The average healing index for callus distraction was 25 days per centimeter. Seven patients had 10 major complications that necessitated additional operative procedures. There were 4 nonunions. Three patients had an infected nonunion, which was treated with the Ilizarov fixator and polymethyl-methacrylate antibiotic beads. One patient had a hypertrophic nonunion which was treated with plate fixation. Three patients who had an epiphyseal injury had shortening with angular deformity, which was treated by callus distraction. Three patients had a joint contracture, which was treated by the percutaneous tenotomy and Ilizarov fixator. The selection of the type of external fixator depends on the fracture pattern and the Ilizarov fixator is recommended for complicated fracture with severe comminution or segmental bone loss.
Bone Transplantation ; Bony Callus ; Child ; Congenital Abnormalities ; Contracture ; External Fixators ; Femur ; Follow-Up Studies ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Humans ; Ilizarov Technique ; Joints ; Surgical Procedures, Operative ; Tenotomy ; Tibia

No abstract available.
Antiemetics* ; Cisplatin* ; Dexamethasone* ; Humans ; Lorazepam* ; Metoclopramide* ; Ondansetron*

The purpose of this study was to examine dietary attitudes of students and changes in their attitudes toward the school lunch service. The participants of the study were 483 students ranging from third grade elementary school students to middle school sophomores living in the Seoguipo area of Jeju Island. The subjects were asked to complete questionnaires under the supervision of their teachers or dietitians, and data were grouped into elementary school 3rd and 4th grades, elementary school 5th and 6th grades; and middle school 1st and 2nd grades for each gender. There were no significant differences among the groups with respect to their regularity of food intake, dietary considerations, or the frequency of imbalance in their diets. In the case of female participants, their frequency of snacking decreased as their grade level increased. In general, the overall changes in dietary attitudes became more negative as their grade level increased. Male students demanded increased serving sizes of both staple food and side dishes, while female students demanded increased serving sizes dishes, but not staple food as their grade levels increased. there was also an increase in the number of student sin higher grades who discarded or did not eat enough their entire meals. The major reasons for not eating the food were : no taste to the food and not proper saltiness of food. These results may suggest that school dietitians need to pay more attention to increased taste and proper seasoning of meals. Students suggested that the school lunch service should be continued, but that it needs improvement. Students in higher grades were more aware of the importance of the environment in which the meal was provided. Also, an early education in nutrition and healthy diets seemed important in preparing them for following a healthy lifestyle in later life.
Diet ; Eating ; Education ; Female ; Food Habits ; Humans ; Life Style ; Lunch* ; Male ; Meals ; Nutritionists ; Organization and Administration ; Seasons ; Serving Size ; Snacks ; Surveys and Questionnaires

Background: Many countries need help with the problem of an unbalanced distribution of physicians and hospitals. Moreover, various policies and strategies have been proposed to solve this problem. This study aimed to examine the determinants of the unbalanced distribution of physicians. Methods: From the 2020 Korean Physician Survey data, 4,181 physicians practicing in Korea were limited to the subjects of the study. We analyzed the factors influencing physicians’ choice of practice location and their willingness to change their practice location from an urban to a rural area. Results: The region of physicians’ hometown, medical school, and residency training hospitals determined their choice of practice location. The type of affiliated healthcare organization and the location of physicians’ hometown, medical school, and residency training hospitals affected their willingness to change their practice location from an urban to a rural area. Furthermore, the concordance rate of the regions of physicians’ hometown, medical school, and residency training hospitals with the region of their practice location was 24.9%. Conclusion In South Korea, policies for doctors have been designed without considering why they are reluctant to work in rural hospitals. To have a balanced distribution of physicians and hospitals, it is necessary to accurately analyze the status of medical resources based on regions and identify the current and future medical demand. The social situation, such as future demographic change and regional extinction, must also be fully considered. Furthermore, policies should be implemented that encourage physicians to work in rural hospitals.

Because operationg room time is one of the most expensive hospital resources, cancellation of a planned surgery is a wasteful expenditure of specialized human manpower and other medical resources. To decrease the rate of cancellation, we performed this prospective study about patients who planned elective surgery under general or regional anesthesia frome September 1, 1990 to December 31, 1990 in the operating room of Yeungnam University Hospital. Daily, the total number of planned surgeries and cancelled patients were recorded, and the most important reasons for cancelling by an individual patient were also recorded. The results were as follows: 1)The total number of planned elective surgeries was 3,102 patients and total number of cancelled patients was 502 patients. Thus the mean rate of cancellation was 16.2%. 2)The highest rate of cancellation was in October(21.2%), and the departmental variation was hte highest rate in dental(37.5%) and the lowest rate in the ophthalmic department(8.6%). 4) The reason of cancellation were as follows: combined systemic diseases or abnormal laboratory findings(42.4%) were most common, and the next was no admission(14.5%), heavy schedule or deficinecy of operating room(10.3%), refusal of operation(8.6%), insufficinet patient preparation(7.8%), and affairs of operator or department(7.4%), and others. As a result of this study, there are several ways to decrease the cancellation rate in operating room of yeungnam University Hospital. The first is a careful preoperative evaluation of patient's physical status and results of labaratory examination before hospitalization, and then the common practice of outpatient surgery, appropriate plan of overall elective operation, reasonable management of an operating room, and good relationships between the individual department, especially surgeons and concultant. If we follow the above mentioned ways, disruptions of the surgical schedules may be avoided and a more economical management of the operationg room is possible.
Ambulatory Surgical Procedures ; Anesthesia, Conduction ; Appointments and Schedules ; Disulfiram ; Health Expenditures ; Hospitalization ; Humans ; Operating Rooms ; Prospective Studies

Apert syndrome is characterized by a hyperacrobrachycephalic skull with a flattened occiput, and malformations of the midface, hands and feet, as well as complicated multiple craniosynostosis and dysmorphism of the skull. Several authors have recently reported in the treatment of complicated skull anomalies that simple x-ray and axial/coronal CT imaging cannot provide sufficiently precise information, and presurgical planning cannot be based on the findings of these procedures ; three-dimensional(3D) reconstruction of CT images is, instead, needed. By means of a computerized simulation, the authors reformatted skull contour on a monitor using the method of splitting and remodeling a 3D skull image. Surgery was performed and the result was good. Presurgical computerized simulation was thus shown to be very helpful for the surgical correction of complicated craniosynostosis.
Acrocephalosyndactylia ; Craniosynostoses ; Foot ; Hand ; Skull*

Apert syndrome is characterized by a hyperacrobrachycephalic skull with a flattened occiput, and malformations of the midface, hands and feet, as well as complicated multiple craniosynostosis and dysmorphism of the skull. Several authors have recently reported in the treatment of complicated skull anomalies that simple x-ray and axial/coronal CT imaging cannot provide sufficiently precise information, and presurgical planning cannot be based on the findings of these procedures ; three-dimensional(3D) reconstruction of CT images is, instead, needed. By means of a computerized simulation, the authors reformatted skull contour on a monitor using the method of splitting and remodeling a 3D skull image. Surgery was performed and the result was good. Presurgical computerized simulation was thus shown to be very helpful for the surgical correction of complicated craniosynostosis.
Acrocephalosyndactylia ; Craniosynostoses ; Foot ; Hand ; Skull*

Reflex sympathetic dystrophy is a common posttraumatic pain syndrome for which no relia- bly effective method of therapy has been found. Oral therapy has been attempted with steroid, tricyclic antidepressant, beta-blocker, and antiseizure medications, none of which are predictably helpful. Multiple invasive treatment, including sympathetic blockade and intravenous regional local anesthetic, reserpine, or guanethidine blocks, have been employed, but again with inconsistent success. Transcutaneous nerve stimulation is effective in some patients but aggravates symptoms in others. Following a report of the use of subarachnoid block in the treatment of reflex sympathetic dystrophy, a symptom that is characterized by vasospasm and cold intolerance, we experienced the ability of subarachnoid block to relieve the symptoms of reflex sympthetic dystrophy.
Guanethidine ; Humans ; Reflex Sympathetic Dystrophy* ; Reflex* ; Reserpine ; Transcutaneous Electric Nerve Stimulation

PURPOSE: Electrogastrography is a method of measuring action potentials of the stomach. The purpose of this study was to investigate early postoperative changes in the electrogastrography and determine the correlation between electrogastrography and quality of life of patients with stomach cancer who underwent distal gastrectomy. MATERIALS AND METHODS: This study analyzed 20 patients with stomach cancer who underwent electrogastrography and quality of life was measured 1, 12, and 24 weeks after the operation. Quality of life-C30 version 3.0 and quality of life-STO22, were used. RESULTS: Fasting and postprandial mean dominant frequency at 1 week after the operation was 2.7 and 2.7 cycles per minute, and 2.8 and 2.7 cycles per minute at 12 weeks, 2.6 and 2.8 cycles per minute at 24 weeks. Fasting and postprandial mean dominant power at 1 week was 36.5 and 36.4 dB, 36.3 and 40.1 dB at 12 weeks and 40.9 and 42.3 dB at 24 weeks. The percentage of tachygastria was increased whereas the percentage of bradygradia was decreased during the postoperative periods (P<0.05). Global health, physical, emotional and social functioning scales were improved, but role and cognitive functioning were not changed. Pain, insomnia, diarrhea and financial difficulties were significantly improved according to the postoperative periods (P<0.05). The correlation between the STO22 and electrogastrography parameters was not significant (P>0.05). CONCLUSIONS: These may suggest that electrogastrography is a simple and noninvasive method and may be applicated for evaluating motility and autonomic functions of the remnant stomach.
Action Potentials ; Diarrhea ; Fasting ; Gastrectomy* ; Gastric Stump ; Humans ; Postoperative Period ; Quality of Life ; Sleep Initiation and Maintenance Disorders ; Stomach Neoplasms* ; Stomach* ; Weights and Measures

PURPOSE: The purpose of this study was to investigate the status of infection control in long-term care facilities in Korea and educational needs of nurses in charge of infection control. METHODS: This was a descriptive study. A self-reported questionnaire was provided to the nurses in charge of infection control in 250 hospitals with long-term care. 209 nurses answered to the questionnaire. Data were collected from September 30 to November 7, 2016. Data were analyzed using SPSS/WIN 18.0, and the educational needs were analyzed by applying the Borich Needs Assessment Model. RESULTS: Only 17.4% of the hospitals had infection control departments, and only 1.0% of the hospitals had nurses who were fully-in-charge of infection control. Regarding the educational needs on infection control, level of knowledge was statistically significantly lower in all 50 items compared to the importance. Specifically, educational demand on air and water quality management, construction and infection control, indicator management, and infectious disease management were also high. CONCLUSION: The results of this study showed that organization and manpower were needed for effective infection control of long-term care facilities in Korea. In addition, it was deemed necessary to develop and applicate infection control education programs as reflected on the scores obtained in the educational needs on infection control.
Communicable Diseases ; Education ; Infection Control* ; Korea* ; Long-Term Care* ; Needs Assessment ; Water Quality