This study aimed to investigate the clinical characteristics and outcomes of patients involuntarily admitted to the psychiatric unit of a university hospital without an emergency psychiatric inpatient ward. We retrospectively analyzed 22 patients (0.53% of 4,133 total admissions) involuntarily admitted to our neuropsychiatric ward between April 1, 2010 and March 31, 2020. The findings revealed that 59.1% of the patients were diagnosed with schizophrenia spectrum disorders and 59% of them were at risk of harming others. Additionally, 63.6% were transferred from other psychiatric facilities, and 59.1% required treatment of physical comorbidities, primarily endocrine disorders. The median duration until lifting of involuntary hospitalization was 30 days, with 54.5% of patients being transferred to other facilities and 45.5% being discharged from our hospital and went home. No significant associations were found between the outcomes and factors, such as transfer status, presence of physical comorbidities, and multiple involuntary hospitalizations. Although our facility predominantly treats patients with schizophrenia spectrum disorders and physical comorbidities who were transferred from other institutions and approximately 40% of the patients in this study were discharged from our hospital, we could not identify specific factors that significantly influenced patient outcomes.

The auricle is an organ of both aesthetic and functional importance and requires appropriate reconstruction in cases of traumatic loss. In this study, we report a case of an 11-year-old boy whose upper auricle was completely amputated due to a fall. The severed portion was initially reattached and managed as a free composite tissue graft. However, partial necrosis subsequently occurred, resulting in contracture and helical rim deformity, necessitating reconstruction. After debridement of the necrotic tissue, reconstruction was performed using a conchal cartilage graft and posterior auricular skin valve. Postoperatively, helical rim contour preservation and functional improvement of the auricle were observed at 3 months and complete flap survival was confirmed at 7 months. Conchal cartilage grafting combined with posterior auricular flap placement appears to be an effective and minimally invasive reconstructive method for repairing helical rim defects.

A 10-year-old boy with Marfan syndrome underwent sternal elevation for severe pectus excavatum accompanied by severe scoliosis. Although the Nuss procedure was attempted, manual elevation of the sternum was impossible due to great resistance. Intraoperative change to the modified Ravitch procedure brought sufficient correction of the depressed sternum. The modified Ravitch procedure might be optimal for severe pectus excavatum accompanied by severe scoliosis because it generates no corrective stress on the thoracic vertebrae, which may cause acceleration of the existing scoliosis.