Previous research has shown that lack of sleep is related to Body Mass Index (BMI) in adolescence. This study was designed to investigate the association between sleep duration and BMI among Korean adolescents. We conducted a school-based cross-sectional study of 3,785 adolescents (males: 58.2%, females: 41.8%) in middle and high school between the ages of 11 and 18 years (mean age 15.26 ± 1.45). Using a self-reported questionnaire, we obtained information regarding weekday sleep duration, weekend sleep duration, height, weight, time spent at private tutoring institutes, socioeconomic status and scores on the Beck Depression Inventory (BDI). We investigated the association between self-reported sleep duration and BMI. After adjusting for confounding factors including age, gender, time spent at private tutoring institutes, academic performance, economic status and BDI scores, longer sleep duration on both weekdays and weekends was associated with decreased BMI (P = 0.002 and P < 0.001, respectively) for both genders. Increased weekend catch-up sleep duration was associated with decreased BMI in females (P = 0.038), but not in males (P = 0.343). The results of the present study indicated that longer sleep duration on weekdays and weekends in adolescents was associated with lower BMI. Longer weekend catch-up sleep may compensate effects of insufficient sleep on BMI for female adolescents.
Academies and Institutes ; Adolescent* ; Body Mass Index* ; Cross-Sectional Studies ; Depression ; Female ; Humans ; Male ; Social Class

Objective: To demonstrate the effects of chin-down maneuver on swallowing by using high-resolution manometry (HRM). Methods: HRM data of 20 healthy subjects and 64 dysphagic patients were analyzed. Participants swallowed 5 mL of thin and honey-like liquids in neutral and chin-down positions. HRM was used to evaluate maximal velopharyngeal pressure/area, maximal tongue base pressure/area, maximal pharyngeal constrictor pressure, pre-/post-swallow upper esophageal sphincter (UES) peak pressure, minimal UES pressure, UES activity time, and nadir duration. Results: Compared to the neutral position, the chin-down maneuver significantly increased tongue base pressure in both normal and dysphagic groups as well as for both honey-like and thin viscosities, although the honey-like liquid did not reach statistical significance in the dysphagic group. Regarding pharyngeal constrictors and pre-swallow peak UES pressure, the healthy group showed a significant decrease in thin liquid swallowing and decreasing tendency in honeylike liquid swallowing. UES nadir duration was significantly decreased for honey-like liquid swallowing in the dysphagic group and for both thin and honey-like liquids in the healthy group. UES nadir duration of honey-like and thin flow swallowing in the dysphagia group was 0.26 seconds after the chin-down maneuver, which was severely limited. Conclusion This study showed a different kinetic effect of the chin-down maneuver between the healthy and dysphagic groups, as well as between thin and honey-like viscosities. The chin-down maneuver increased tongue base pressure and decreased UES nadir duration, which the latter was severely limited in dysphagic patients. Therefore, appropriate application of the chin-down maneuver in clinical practice is required.

Pulmonary atresia with intact ventricular septum has continued to have a high mortality and morbidity. The initial palliation is commonly a pulmonary valvotomy to achieve right ventricular decompression with or without a systemic to pulmonary shunt. There are only a few publications reporting practical experience with ductal stenting in neonates with pulmonary atresia. We report a case of pulmonary valvotomy followed of PDA stent insertion for the treatment of pulmonary atresia with intact ventricular septum.
Balloon Valvuloplasty* ; Decompression ; Humans ; Infant, Newborn ; Mortality ; Pulmonary Atresia* ; Stents* ; Ventricular Septum*

Benign Schwannoma rarely involves the vertebral bodies extensively. Despite of huge amount of neoplastic mass and severe destructive bony changes, the neurologic deficits could not be discovered. The authors discussed the findings of plain X-rays, cervical CT, MRI, pathology as well as surgical procedure, and reviewed the literatures.
Magnetic Resonance Imaging ; Neurilemmoma* ; Neurologic Manifestations ; Pathology

PURPOSE: Doubly committed juxtaarterial ventricular septal defect(DCJA VSD) is relatively more frequent among Asians with VSD. The potential impairments of growth of pulmonic annulus and function of pulmonary valve are possible in postoperative patients due to the anatomic location of defect. But there are few reports regarding those impairments. So we evaluated growth of the pulmonic annulus and function of pulmonic valve after an operation. METHODS: Between Jan. 1995 and Dec. 1996, twenty seven patients with DCJA VSD were operated in Dong-A University Hospital. To compare with the study group, we selected 14 perimembranous VSD patients with similar ages and body weights who were operated during same period. We reviewed medical records and video tapes for 2 years-postoperative echocardiographic findings retrospectively. Main pulmonary artery annulus and aortic annulus ratio(MPA/Ao ratio) was used to evaluate the relative growth of pulmonary artery, and we also checked the severity of pulmonic stenosis related to valvar dysfunction. RESULTS: Two years after the operation, the MPA/Ao ratio decreased significantly in DCJA VSD patients(P value 0.001, and the decrease showed positive correlation with the defect size which is standardized by defect size/aortic annulus ratio. The mean gradient through pulmonic valve was 15.68+/-5.87, but it was not influenced by defect size or severity of growth retardation of MPA. CONCLUSION: The repair of DCJA VSD can induce the growth retardation of pulmonic annulus and valvar stenosis of pulmonary artery.
Asian Continental Ancestry Group ; Body Weight ; Constriction, Pathologic ; Echocardiography ; Heart Septal Defects, Ventricular* ; Humans ; Medical Records ; Pulmonary Artery* ; Pulmonary Valve ; Pulmonary Valve Stenosis ; Retrospective Studies

OBJECTIVE: Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI. METHODS: A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome. RESULTS: Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion (2.2 +/- 1.2 days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect (1.5 +/- 0.9 days), epilepsy (2.7 +/- 1.5 days), cerebrospinal fluid leakage through the scalp incision (7.0 +/- 4.2 days), and external cerebral herniation (5.5 +/- 3.3 days). Subdural effusion (10.8 +/- 5.2 days) and postoperative infection (9.8 +/- 3.1 days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at 79.5 +/- 23.6 and 49.2 +/- 14.1 days, respectively). CONCLUSION: A poor GCS score (< or = 8) and an age of > or = 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.
Brain Injuries ; Contusions ; Decompressive Craniectomy ; Epilepsy ; Hematoma ; Humans ; Hydrocephalus ; Incidence ; Intracranial Pressure ; Retrospective Studies ; Scalp ; Subdural Effusion

BACKGROUND AND OBJECTIVES: Vocal polyps and nodules are representative chronic benign laryngeal diseases, and voice overuse, misuse, and abuse are felt by most authors to be the primary causative factors. Treatment options for vocal polyps and nodules in general include voice therapy by a speech-language pathologist and laryngeal microsurgery. The purpose of this study was to determine the changes in voice quality of a group of patients diagnosed with vocal polyp or vocal nodule before and after microlaryngeal surgery. MATERIALS AND METHOD: The following patients groups were studied prior to and 2 weeks after surgery: thirty-eight males, ages 27 to 62, and twenty five females, ages 23 to 47, with vocal polyp: three males, ages 29 to 38, and twenty eight females, ages 21 to 49, with vocal nodules. Voice recordings of the first sentence of a standardized paragraph "San Chaek" were performed for acoustic analyses. The recorded samples were analyzed on the Kay CSL model 4300B using Visi-Pitch II program. For the sentence, mean speaking fundamental frequency (F0), mean jitter and mean shimmer were analyzed. RESULTS: For the polyps, male patients showed decreased mean F0 (119.28 Hz), compared to the preoperative value (125.86 Hz) (p<0.05), and female patients showed increased mean F0 (197.52 Hz), compared to the preoperative value (190.07 Hz) (p=0.06). Mean jitter and shimmer improved in both males and females 2 weeks after surgery compared to their preoperative value (p<0.01). For the nodules, male patients showed decreased mean F0 (136.24 Hz) compared to the preoperative value (138.68 Hz), and female patients showed increased mean F0 (199.98 Hz) compared to the preoperative value (192.61 Hz) (p<0.05). Mean jitter and shimmer improved in both males and females 2 weeks after the surgery compared to their preoperative value. CONCLUSION: The acoustic output generally improved after laryngeal microsurgery as evidenced by the more appropriate mean F0 and reduced level of vocal perturbation. And, mean F0 showed different changes between males and female. Further research needs to be pursued on what this changes of mean F0 mean.
Acoustics ; Female ; Humans ; Laryngeal Diseases ; Male ; Microsurgery* ; Polyps* ; Voice Quality* ; Voice*

The Korean Society of Laryngology, Phoniatrics and Logopedics created a task force to establish clinical practice guidelines for the use of botulinum toxin (BT) in otolaryngology. We selected 10 disease categories: spasmodic dysphonia, essential vocal tremor, vocal fold granuloma, bilateral vocal fold paralysis, Frey’s syndrome, sialocele, sialorrhea, cricopharyngeal dysfunction, chronic sialadenitis, and first bite syndrome. To retrieve all relevant papers, we searched the CORE databases with predefined search strategies, including Medline (PubMed), Embase, the Cochrane Library, and KoreaMed. The committee reported 13 final recommendations with detailed evidence profiles. The guidelines are primarily aimed at all clinicians applying BT to the head and neck area. In addition, the guidelines aim to promote an improved understanding of the safe and effective use of BT by policymakers and counselors, as well as in patients scheduled to receive BT injections.

PURPOSE: Postoperative hypocalcemia is a common complication of thyroidectomy. This study evaluated the incidence and predisposing risk factors for postoperative permanent hypocalcemia after total thyroidectomy. METHODS: There were 1,247 consecutive patients undergoing total thyroidectomy and complete treatment and observation for differentiated thyroid cancer between January 2012 to December 2012 who were enrolled in this study. Patients were divided into two groups, those remaining normalcalcemic (Group I-824 pts) and those who had hypocalcemia requiring treatment (Groups II-423 pts). Group II was subdivided into a transient hypocalcemic group (Group IIA-409 pts) and a permanent hypocalcemic group (Group IIB-14 pts). RESULTS: Female gender, thyroiditis, preserved parathyroid number, lateral lymph node metastasis, RAI treatment, preoperative parathyroid hormone and preoperative vitamin D were significantly associated with the development of postoperative hypocalcemia by multivariate analysis. Comparing patients with transient versus permanent hypocalcemia, tumor size and multiplicity were significantly related to the development of permanent hypocalcemia by multivariate analysis. RAI treatment and parathyroid hormone level on the postoperative third day were significantly related to recovery from transient hypocalcemia to normo-calcemia. CONCLUSION: Risk factors of postoperative hypocalcemia were associated with preoperative patient factors and advanced thyroid cancer. Advanced thyroid cancer was a risk factor for permanent hypocalcemia. To prevent postoperative hypocalcemia, we should focus on patient condition and need to preserve parathyroid gland more carefully in thyroid surgery.
Female ; Humans ; Hypocalcemia* ; Incidence ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Parathyroid Glands ; Parathyroid Hormone ; Risk Factors* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Thyroiditis ; Vitamin D

Background/Aims: We investigated whether serum neutrophil gelatinase-associated lipocalin (NGAL) can predict mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). Methods: This study enrolled 169 patients who underwent serum NGAL testing at CRRT initiation from June 2017 to January 2019. The predictive power of serum NGAL level for 28-day mortality was compared to the Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score and Sequential Organ Failure Assessment (SOFA) score via area under the receiver operating characteristic curve (AuROC) value. Results: There were 55 survivors and 114 non-survivors at 28 days post-CRRT initiation. Median serum NGAL level was significantly higher in the non-survivor group than in the survivor group (743.0 ng/mL vs. 504.0 ng/mL, p = 0.003). The AuROC value of serum NGAL level was 0.640, which was lower than APACHEII score and SOFA score values (0.767 and 0.715, respectively). However, in the low APACHE-II score group (< 27.5), AuROC value of serum NGAL was significantly increased (0.698), and it was an independent risk factor for 28 day-mortality (hazard ratio, 2.405; 95% confidence interval, 1.209 to 4.783; p = 0.012). Conclusions In patients with AKI requiring CRRT, serum NGAL levels may be useful for predicting short-term mortality in those with low APACHE-II scores.