The influences of adrenal corticosteroid on the development and regression of neurons of dentate and hippocampus were studied by adrenalectomy and steroid overload in neonatal rats. The results obtained were as follows. 1. The cell death occurred naturally in numerous dentate granule cells and hippocampal pyramidal cells. 2. The number of dentate granule cells undergoing cell death decreased by injection of adrenal corticosteroid, but increased in adrenalectomized rat brains. The changes occurred prominently at postnatal day 6. 3. The number of hippocampal pyramidal cells undergoing cell death decreased in CA3 region by injection of adrenal corticosteroid, but was not changed in adrenalectomized rat brains. However, other regions exhibited no change by adrenal corticosteroid and adrenalectomy. 4. The cell death of pyramidal cells of CA3 region occurred in close relationship with the cell death of dentate granule cells, which was different from other CA regions. In summary, the cell death of dentate and hippocampal neurons occurred naturally but seemed to be influenced by other factors as well as adrenal corticosteroid.
Adrenalectomy ; Animals ; Brain ; Cell Death ; Hippocampus* ; Neurons* ; Pyramidal Cells ; Rats*

The Dandy-Wlaker syndrome is a developmental disoeder characterized by cystic dilatation of the fourth ventricle and agenesis or hypoplasia of the cerebellar vermis and is usually associated with hydrocephalus. This syndrome is also associated with intracranial malformations such as agenesis of corpus callosum, and extracranial malformations such as facial anormalies (cleft palate, cleft lip, and ocular anomalies), polycystic kidney, and cardiac anormalies. Reported associated ophthalmic anomalies are microphthalmos, coloboma, and congenital cataract.We experienced a case of infantile esotropia in abnormal insertion and direction of lateral rectus muscle as a variant of the Dandy-Walker syndrome accompanied by cleft palate and cleft lip in a 19-month-old male infant. Subsequent treatment of the 30delta esodeviation and left inferior oblique muscle overaction, including resection of the lateral rectus muscle in both eyes and the myectomy of the inferior oblique muscle in the left eye, yielded satisfactory results, so we report this case, with a review of the pertinent literature, as the first case of Dandy-Walker syndrome associated with esotropia with abnormal course of lateral rectus muscle in Korea.
Agenesis of Corpus Callosum ; Cleft Lip ; Cleft Palate ; Coloboma ; Dandy-Walker Syndrome* ; Dilatation ; Esotropia* ; Fourth Ventricle ; Humans ; Hydrocephalus ; Infant ; Korea ; Lip ; Male ; Microphthalmos ; Polycystic Kidney Diseases

"The purpose of this study was to obtain basic data of nutrition education for obese children in Seoul and to examine dietary habits, dietary behaviors, and body image recognition before and after nutrition education. A convenience sample of 69(male : 54, female : 15) obese children was selected from "98 Children Nutrition Camp" in Seoul. The survey design employed a structured questionnaires. The results of this study were summarized as follows ; 1. Anthropometric parameters such as height, weight were measured in 69 obese subjects of age 10~12. 2. Effects of nutrition knowledge were gained by dietary habits, dietary behaviors and body image recognition. 3. Comparison of nutrition knowledge scores for obese children was to obtain basic data of effects for nutrition education. "
Body Image* ; Child* ; Education* ; Female ; Food Habits* ; Humans ; Surveys and Questionnaires ; Seoul*

OBJECTIVE: The purpose of this study was to develop the decision tree models to classify the characteristics of those who had not undergone the health screening tests provided by the National Health Insurance Corporation. METHODS: Total of 5,102,761 subjects of health screening services in the year of 2002 was used. The data was divided into two data-sets (disease VS. non-disease group). The target variable was whether they took the health screening services. The number of input variables was 25 in total. RESULTS: The decision trees were classified into fourteen different types of non-examinees in the non-disease group and nineteen in the disease group. The ROC curve areas in the non-disease and disease groups were .761 and .714, respectively. CONCLUSION: The different types of non-examinees classified by the decision tree models would facilitate the foundation for the further analysis of individual characteristics and the effective health screening service management in future.
Data Mining ; Decision Trees* ; Mass Screening* ; National Health Programs ; ROC Curve

OBJECTIVE: To understand the clinical manifestations and disease course of adult onset Still' s disease (AOSD). METHODS: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. RESULTS: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia' Hgb <10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root joint arthritis and polyarthritis were factors associated with chronicity. CONCLUSION: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.
Adult* ; Arthritis ; Chronic Disease ; Exanthema ; Female ; Ferritins ; Fever ; Hepatomegaly ; Humans ; Joints ; Leukocytosis ; Liver ; Lymphatic Diseases ; Male ; Pharyngitis ; Prevalence ; Retrospective Studies ; Serositis ; Splenomegaly ; Still's Disease, Adult-Onset*

Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.
Aged ; Critical Illness* ; Delayed Diagnosis ; Headache ; Humans ; Intensive Care Units ; Male ; Neurologic Manifestations ; Posterior Leukoencephalopathy Syndrome* ; Postoperative Period ; Seizures

We have studied the efficacy of intravenous clonidine to suppress postoperative shivering. Forty healthy patients who received general anesthesia and required treatment for shivering after operation were allocated randomly to two groups. Group 1 received normal saline 5 ml. Group 2 received 75 mcg intravenous clonidine. 2 minutes, 5 minutes and 10 minutes after treatment, the efficacy of treatment was recorded. Five minutes after treatment, 75 mcg clonidine obliterated shivering in 80% of patients. In contrast, none of the patients treated with normal saline had improved. Mean arterial pressure and heart rate were decreased significantly in patients given 75 mcg intravenous clonindine. But, none of them had required treatment for hypotension or bradycardia. We might say that 75 mcg intravenous clonidine is effective to suppress postoperative shivering without significant side effects.
Anesthesia, General* ; Arterial Pressure ; Bradycardia ; Clonidine* ; Heart Rate ; Humans ; Hypotension ; Shivering*

OBJECTIVES: Sharing of cancer-related information among healthcare professionals is crucial to ensuring the quality of long-term care for cancer survivors. Appropriate distribution of the essential facts can be achieved using data models. The purpose of this study was to develop and validate suitable data models for use in the nursing assessment of cancer survivors. METHODS: The models developed in this study were based on a modification of concept analysis developed by Walker and Avant. Our approach involved determining the purpose of the analysis, identifying data elements, defining these elements and their uses, determining critical attributes, value sets, and cardinalities, and ultimately constructing data models which were examined externally by domain experts. RESULTS: We developed 112 data models with 112 data elements, 29 critical attributes, 102 value sets, and 6 data types for the assessment of cancer survivors. External validation revealed that the data elements, critical attributes, and value sets proposed were comprehensive, relevant, and sufficiently useful to encompass nursing issues related to cancer survivors. CONCLUSIONS: Data models developed in this study will contribute to ensuring the semantic consistency of data collected from cancer survivors, which will improve the quality of nursing assessments and in turn translate to improved long-term patient care.
Delivery of Health Care ; Electronic Health Records ; Humans ; Long-Term Care ; Nursing Assessment ; Patient Care ; Quality of Health Care ; Semantics ; Standard of Care ; Survivors

The purpose of this study is to investigate the effects of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with vecuronium and atracurium. Following intravenous injection of either vecuronium (40 patients) or atracurium (40 patients), recovery index (RI) was measured without administering either doxapram or neostigmine (Group 1), or after administration of a combination of neostigmine 40 ug/kg and doxapram 1 mg/kg (Group 2), neostigmine 40 ug/kg (Group 3) or doxapram 1 mg/kg (Group 4) when twitch tension returned to 25% block of train of four response, each of the four group had 10 patients. The results were such that RI was significantly prolonged after vecuronium in the presence of doxapram compared with Group 1 (13.5 min vs 8.2 min). There was no significant difference in the RI after atracurium in the presence of doxapram compared with Group 1 (7.0 min vs 7.1 min). There was rapid recovery which was significant when neostigmine was administered with or without doxapram (2.4 min vs 2.3 min respectively after vecuronium; 2.3 min vs 2.4 min respectively after atracurium). The authors conclude that administration of doxapram in situation where neuromuscular block with vecuronium is not adequately antagonized does not contribute to rapid recovery from neuromuscular block.
Atracurium* ; Doxapram* ; Humans ; Injections, Intravenous ; Neostigmine ; Neuromuscular Blockade ; Vecuronium Bromide*

Following the introduction of instrumentation for phacoemulsification and vitctomy, many other devices have been deaigned to perform the functions. In the past, there was a serious prblem that fluid flowed from the eye along the path of least resistance and the dutflow rate varied greatly with viscosity and consistency of material in the line. Recently a new computerized instrument the Heslin/Mackool Ocusystem that overcame these flow problems was developed and we studied about early experiences using this new helper. The results were as follows: 1. There was an advantage for time and place due to a single instrument and simple change from E.C.C.E. to vitrectomy. 2. The rupture of posterior capsule in aphakic group and the remained cortical material in pseudophakic group were the most common surgical complications during operation. 3. Descemet's membrane stripping was developed in a high rate due to the sharp titanum-covered cap of the handpiece for phacoemulsification. 4. The posterior capsule opacity was the most common postoperative complication in the group of visual acuity less than 0.5.
Descemet Membrane ; Phacoemulsification* ; Postoperative Complications ; Rupture ; Viscosity ; Visual Acuity ; Vitrectomy*