No abstract available.
Craniosynostoses*

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

PURPOSE: The buttocks region has been associated with allure and sex appeal for centuries. Gluteal implants enable buttocks remodeling in a way that is not possible in other methods. One of the reasons that render gluteal implant surgeries unpopular is the fear of complications, the main problems being seroma, wound dehiscence, extrusion, and a visible or palpable implant. The authors present the XYZ technique, which provides anatomical reference points to guide the intramuscular dissection procedure in a feasible and safe way, resulting in a lower complication rate. METHODS: The XYZ procedure was done for buttock augmentation on 8 patients from December 2009 to June 2010. Patient's ages ranged from 27 to 44 with a mean age of 36. Seven patients were applied the 250cc sized Elastomer implants with one patient 290cc sized implant. Preoperative marking was done with the patients in the standing position. Bisection of the gluteus maximus muscle was done at the midpoint thickness to create a plane for implant insertion, which is called the sandwich plane. RESULTS: The 8 cases were performed safely without major complications. However one patient had minor wound dehiscence, and was managed with conservative treatment. Another patient had a discomfort on the buttocks for a long time. The patients were followed up for average 6 months. All patients were satisfied with the aesthetic results. CONCLUSION: In performing the XYZ technique for gluteal augmentation, the surgeon must split the muscle into two equal halves with anatomical reference points to guide the muscle detachment in a symmetrical way at an adequate depth. This method provides a guideline for the surgeon in determining the ideal plane during intramuscular dissection and gives predictable results with low complication rates. Intramuscular gluteoplasty with gluteal implants offers predictable, aesthetically pleasing results without contour irregularities and only a low incidence of major complications.
Buttocks ; Elastomers ; Humans ; Incidence ; Muscles ; Seroma

No abstract available.
Ulcer*

Therapeutic irradiation can induce angiosarcoma. Radiation-induced angiosarcoma constitutes 20% of all angiosarcomas. Although its common site of origin is the skin and subcutaneous tissue, it rarely arises in small or large bowels with a presentation as multifocal abdominal angiosarcomatosis. We report a case of intra-abdominal angiosarcomatosis involving the jejunum, ileum, transverse colon, mesentery and right ovary in a 63-year-old female. It developed 10 years after therapeutic irradiation for squamous cell carcinoma of uterine cervix. She developed panperitonitis due to intestinal perforation. She died from sepsis 3 days after segmental resection of the small bowel and right oophorectomy. We reviewed the previously reported cases and describe the clinicopathologic features of this tumor.
Carcinoma, Squamous Cell ; Cervix Uteri ; Colon, Transverse ; Female ; Hemangiosarcoma ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Mesentery ; Middle Aged ; Ovariectomy ; Ovary ; Sepsis ; Skin ; Subcutaneous Tissue

Radiation therapy is used for the palliative treatment of malignant tumors and the radiation induced osteonecrosis is one of the well documented complications. Especially, in pelvic region, there are a few reports for osteonecrosis of the femoral head and acetabulum after the radiation therapy for the the malignant tumors such as cervical carcinoma or prostatic cancer. Roentgenographic changes that are caused by radiation include the rarefaction of bone and coarsening of the trabeculae. The radiolucencies tend to coalesce and patchy sclerosis appears. In acetabular region, this Pagetoid appearance mimics the findings of other malignant bone tumors, the recurrence of preexisting malignant peivic tumors and other infectious condition. After the diagnosis is confirmed, the treatment for the femoral head and acetabulum is also difficult. The authors report one case of osteonecrosis of the femoral head and acetabulum following radiation therapy which had many difficulties in its diagnosis and treatment.
Acetabulum* ; Diagnosis* ; Head* ; Osteonecrosis* ; Palliative Care ; Pelvis ; Prostatic Neoplasms ; Recurrence ; Sclerosis

We analyzed the factors of importance for nonunion in series of 91 open fractures of tibial diaphysis which were treated with external fixation. Factors analyzed included, age and sex of the patients, the mechanism of injury, the amount of soft tissue damage, the grade of comminution, the level at which the tibia was fractured, the presence of an intact fibula, the presence of the multiple injuries, the type of the external fixation used(AO external fixator, EXTOR; monotube external fixator, Ilizarov), and the need to supplement the stability of the reduction. We found that the amount of soft tissue damage and comminution of the fracture played a role in the development of the nonunion.
Diaphyses ; External Fixators ; Fibula ; Fractures, Open ; Humans ; Multiple Trauma ; Tibia ; Tibial Fractures*

Eight neonates with transient tricuspid insufficiency are presented which was confirmed clinical and two dimensional echocardiographic assessment. We found that two dimensional Doppler echocardiography was very useful in the detection of transient tricuspid insufficiency during neonatal age as noninvasive method. Transient tricuspid insufficiency is a clinical disorder in the newborn period caused by myocardial dysfunction, secondary to asphyxia with or without hypoglycemia and associated with right ventricular overloading caused by pulmonary hypertention. The clinical diagnosis was based on a history of perinatal distress, distinctive murmur, ECG changes, biochemical abnormalities and myocardial imaging. 1) The sex ratio of TTI was 1:1. 2) The average gestational age was 34 weeks and mean body weight was 2.06 Kg, respectably. 3) Major symptoms were dyspnea, cyanosis, and tachypnea. 4) Tricuspid regurgitation was detected from the lst day to the 4th day of the life and was improved from the 7th day to the 30th day of the life. 5) The peak velocity through tricuspid valve ranged from the 2.7 m/sec to 4.0 m/sec and the estimated right ventricular pressure ranged from 39 mmHg to 74 mmHg. 6) Associated diseases were neonatal hyperbilirubinemia (100%), prematurity (87.5%), atrial right to left shunt (87.5%), patent ductus arteriosus (75%), hyaline membrane disease (25%), and transient tachypnea of newborn (12.5%).
Asphyxia ; Body Weight ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography* ; Echocardiography, Doppler ; Electrocardiography ; Gestational Age ; Humans ; Hyaline Membrane Disease ; Hyperbilirubinemia, Neonatal ; Hypoglycemia ; Infant, Newborn ; Sex Ratio ; Tachypnea ; Transient Tachypnea of the Newborn ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ventricular Pressure

PURPOSE: This study is a descriptive study to investigate the relevance between pathophysiological subject and examination workbook items for national nurse licensure examination in South Korea and the United States. METHODS: Eight registered nurse licensure examination workbooks published by the Korean nurses association were used for the analysis. Saunders comprehensive review for the national council licensure examination (NCLEX-RN) was used for analysis of those in the United States. The relevance between the subjects in the standard syllabuses of pathophysiology and the registered nurse licensure exam items of these workbooks in South Korea and the United States respectively was analyzed. RESULTS: The Relevance rates in South Korea and the United States were : fundamentals of nursing 6.34% vs 32.12%, adult nursing 25.5% vs 25.92% child health nursing 7.81% vs 21.7%, woman health nursing 5.1% vs 17.07% psychiatric mental health nursing 2.7% vs 7.32%, and community health nursing 0.9% vs 0%. CONCLUSION: the relevance in pathophysiology between the registered nurse licensure exam in South Korea and the United States was high in adult nursing and fundamentals of nursing (especially in the United States). In developing integrated registered nurse licensure exam questions, we should consider pathophysiology as an important subject.
Adult ; Child Health ; Community Health Nursing ; Female ; Humans ; Korea* ; Licensure* ; Nurses ; Nursing ; Psychiatric Nursing ; United States*

Postobstructive pulmonary edema (POPE) is associated with upper airway obstruction and has two different types of mechanism. Type 1 POPE is due to acute airway obstruction and is related to forceful respiratory efforts leading to extremely negative intrathoracic pressure. Type 2 POPE is caused by chronic airway obstruction and occurs after sudden relief of obstruction which drop in airway pressure that can lead to pulmonary edema. We report a case of postobstructive pulmonary edema in a child who has peripharyngeal abscess.
Abscess* ; Airway Obstruction ; Child* ; Humans ; Pulmonary Edema*