Novel use of an ultrasonic bone-cutting device for endoscopic-assisted craniosynostosis surgery

Endoscopic-assisted craniosynostosis surgery is associated with less blood loss and shorter operative times as compared to open surgery. However, in infants who have low circulating blood volumes, the endoscopic approach is still associated with significant blood loss. A major source of blood loss is the bone that is cut during surgery. We discuss the novel use of an ultrasonic bone-cutting device for craniosynostosis surgery, which decreases bone bleeding. This device, which has primarily only been used for spine and skull base surgery, may help reduce blood loss in these infants

A Qualitative Study on the Difference in Organizational Fit of IT Supporting Organizations

For many years, factors that increase the competitive advantage of organizations have been studied in organizational research. For an Information Technology (IT) organization, the main issues are the fitness of the IT and organization strategies and methods for revitalizing IT knowledge management (Earl, 2001; Rathnam, Johnsen, & Wen, 2005; Zack, 2002). However, there are few studies that have evaluated the competitiveness of an organization with reference to the correspondence of these constituent factors with organizational objectives. In this research a multi-contingency view was applied to Korean agencies, and the regional agencies with good performance and those with poor performance were compared with regard to this measure of fitness. The results of this study confirmed that the regions that received a favorable evaluation from experts exhibited good fit overall, and the constituent parts of the organization were consistent with the firm’s objectives

Effect of Intervention Programs for Improving Maternal Adaptation in Korea: Systematic Review

PURPOSE: The purpose of this study was to determine the current state of nursing intervention for maternal adaptation and its' effectiveness in Korea by utilizing a systematic review. METHODS: The PICO(Population-Intervention-Compar ator-Outcome) strategy was established, and 1,720 pieces of literature published during the last ten-year period from four electronic databases were reviewed. Eighteen references that met inclusion and exclusion criteria were finally selected for systematic review. The quality of references using critical appraisal checklist for experimental studies were evaluated, and then systematic review and meta-analysis were conducted. RESULTS: All 18 references were quasi-experimental research design. Most interventions were provided at the hospital and postpartum care center. Maternal adaptation interventions appeared to be of many types, and particularly maternal role education programs were the most common. Confidence in maternal role was used as the most common variable for the maternal adaptati on. Various interventions for helping maternal adaptation in the postnatal period improved maternal confidence, moth er-infant attachment, maternal satisfaction and mother-infant interaction effectively. CONCLUSION: A diversity of nursin g interventions in postnatal period improved various aspects of maternal adaptation. Randomized controlled trials and longitudinal studies are needed in order to verify the effect of interventions for maternal adaptation more clearly

Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer.</p> <p>Methods</p> <p>We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy.</p> <p>Results</p> <p>Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC.</p> <p>Conclusions</p> <p>The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy.</p