PURPOSE: In the case of serious respiratory distress syndrome (RDS) or relapse of clinical appearances after single treatment, we obtained more effective results with multiple-dose surfactant replacement therapy. We carried out this investigation for comparing and observing clinical progress between single-dose (group S) and multiple-dose (group M) pulmonary surfactant treatment group of neonatal RDS. METHODS: We investigated 48 neonates who were diagnosed as RDS and treated with pulmonary surfactant (PS) replacement therapy in NICU of Kyunghee University hospital from January 2002 to March 2004, then we compared and verified clinical progress of 32 neonates in group S with that of 16 neonates in group M. RESULTS: There were no significant statistical differences in average birth weights, average gestational periods, initial pH values of birth, whether operation of resuscitation at that time of birth was made or not, whether prenatal steroid prescription for mother, RDS classification standardized by Bomsel, and ventilation index (VI) before instillation of PS of two groups. However, there was significant statistical difference in a/A PO2 (P< 0.05). We could observe changes of VI and a/A PO2 within 72 hours have been continuously improved at group S rather than group M. In spite of relapses, group M changed for the better after second dose. There were also no significant differences between the two groups in duration of ventilator therapy, mortality within 28 days after birth, intraventricular hemorrhage by complication, retinopathy of premature, necrotizing enterocolitis, chronic lung diseases, sepsis, and DIC. CONCLUSION: In these relapse cases, as there were no significant differences in the mortality rate and the occurence of complication between group S and group M, the requirement of multiple-dose PS replacement therapy which brought improvement of prognosis was emphasized.
Birth Weight ; Classification ; Dacarbazine ; Enterocolitis, Necrotizing ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Lung Diseases ; Mortality ; Mothers ; Parturition ; Prescriptions ; Prognosis ; Pulmonary Surfactants ; Recurrence ; Respiratory Distress Syndrome, Newborn* ; Resuscitation ; Sepsis ; Ventilation ; Ventilators, Mechanical

Much has been tried to avoid the toxicity and increase the quality of local anesthesia during epidural anesthesia. One idea is that a mixture of local anesthetics would give better result than separate in jections. This study was undertaken to compare the use of lidocaine alone in contrast to a lidoca-ine-tetracaine mixture. Thirty three cases of epidural anesthesia were performed at Dae-Jeon Eul Ji Hospital from Jan. to Nov. 1985. The results were as follow; 1) There was no difference in the time of onset of anesthesia between the single k Mixt-ure groups. 2) The duration of anesthesia from the mixture was longer than lidocaine by itself. 3) Muscle relaxation from the mixture was superior to lidocaine alone. 4) Toxicity of the mixture was no more than lidocaine alone. 5) In all the groups, pressure drop in diastole was more than that of systole. The heart rate was normal or slightly increased. In conclusion, the use of the lidocaine-tetracaine mixture was better than lidocaine alone for epidural anesthesia.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Local ; Anesthetics, Local ; Diastole ; Heart Rate ; Lidocaine ; Muscle Relaxation ; Systole

OBJECTIVES: The purpose of this study is to find out the relationship between the traumatic experiences and the prevalence of PTSD among North Korean refugees in South Korea. METHODS: Two hundred North Korean refugees in South Korea were voluntarily participated. Researchers conducted face-to-face interviews and assisted defectors in performing a self-report assessment of this survey. The study questionnaire consisted of demographic characteristics, Traumatic Experiences Scale for North Korean Defectors, and PTSD part of the Structured Clinical Interview for DSM-III-R Korean version. RESULTS: Prevalence rate of PTSD in defectors was 29.5%, with a higher rate for women. In factor analysis, the 25 items of traumatic events experienced in North Korea were divided into three factors: physical trauma, political-ideological trauma, and family-related trauma. In addition, the 19 items of traumatic events during defection were grouped into four factors: physical trauma, discovery and capture-related trauma, family-related trauma, and betrayal-related trauma. In multi-factorial logistic regression analysis, family-related trauma in North Korea had a significant odds ratio. CONCLUSION: Family-related trauma experienced in North Korea is related to the prevalence of PTSD among North Korean refugees in South Korea.
Democratic People's Republic of Korea ; Female ; Humans ; Korea ; Logistic Models ; Odds Ratio ; Prevalence ; Surveys and Questionnaires ; Refugees* ; Stress Disorders, Post-Traumatic*

OBJECTIVE: Lumbar foraminal or extraforaminal disc herniations (FEFDH) have unusual clinical features and higher incidence in elderly patients compared to usual intraspinal canal disc herniations. We evaluated the efficacy of microdiscectomy via paramedian approach for lumbar FEFDH in elderly patients over the age of 65. METHODS: Retrospective study was performed in 68 patients over the age of 65 (23 male and 45 female patients; 71.46±3.87 years) who underwent microdiscectomy via paramedian approach for unilateral lumbar FEFDH causing sciatica. The radiological factors including degree of slippage, presence of instability, disc height, and degree of disc degeneration; pain and functional status by the means of visual analogue scale score, Oswestry Disability Index score, and Macnab classification were analyzed preoperatively and during the postoperative follow-up period of 3 years to evaluate the efficacy of the surgical treatment. RESULTS: Pain and functional status improved according to short- and long-term follow-up evaluations after surgery. Radiological changes following surgery, which can be understood as structural deteriorations and deformations, did not represent patient condition. Nine patients underwent additional surgery due to sustained or recurring leg pain of aggravation of back pain, and fusion surgery was required for 3 patients. Degree of preoperative slippage was the only statistically significant factor related to additional surgery (p<0.05). CONCLUSION: Microdiscectomy via paramedian approach for FEFDH may be a good surgical alternative in elderly patients. Radiological changes after surgery did not show a concordance with patients' actual functional status. The excessive preoperative slippage tended to lead to unfavorable result after surgery and was associated with additional surgery.
Aged* ; Back Pain ; Classification ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Leg ; Male ; Retrospective Studies ; Sciatica

The purpose of this study was to analyze the statistical errors of articles in the Journal of Korean Academy of Periodontology from 1973 to 1999. Of the 662 articles examined, 263 were included which analyzed the data. They were classified into 2 groups with time lapse; group 1: 1973~1989, group 2: 1990~1999. Authors made checklists for analyzing the data and detecting the errors and analyzed them with professional statistician. The results were as follows: 1. Of 263 atricles which applied statistical method, 40(19.3%) was in group 1, 223(49.0%) in group2. 2. In the number of statistical method applied, 170(64.6%) were analyzed with 1 statistical method, 73(27.8%) with 2 methods, 18(6.8%) with 3 methods, and 2(0.8%) with 4 methods 3. The number of statistical methods applied was 14, and they were applied in order of 119 of ANOVA, 72 of Student t-test, 63 of Paired t-test, 36 of CORRELATION, and 21 of Mann-Whitney U test. 4. In 87(33.1%) of 263 articles and in 18 error items, statistical errors were found out. In group I, 9 items (55%) of error were found out, and were in order of 5 of Student t-test instead of Paired t-test, and 4 of unnecessary statistical analysis. In group II, 16 items (29.1%) of error were found out, and were in order of 22 of Student t-test instead of Paired t-test, 7 of no multiple comparison test after ANOVA, 6 of Student t-test instead of ANOVA, 6 of unnecessary statistical analysis, and 5 of ANOVA instead of Paired t-test. In conclusion, the results noted that statistical analyses were increased, but statistical errors were decreased with time. But authors suggest that researchers should refer to standard statistical texts and seek advice from professional statisticians to avoid the statistical errors.
Checklist ; Humans

Biliary cystadenoma is a rare tumor that arises in the liver or, less frequently, in the extrahepatic ducts. Jaundice in patients with biliary cyst adenoma is not uncomon, but it is very rare that the jaundice is caused by tumor compression of the bile duct. A 43-year-old woman who had a huge biliary cystadenoma occupying the left liver developed deep jaundice. Endoscopic retrograde cholangiopancreatograpy demontrated that this tumor compressed the common hepatic ducts extrinsically which caused the deep jaundice.
Adenoma ; Adult ; Bile Ducts ; Cystadenoma* ; Female ; Hepatic Duct, Common* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Liver

PURPOSE: Patients with work related burns suffer from anxiety, depression, insomnia and suicide ideation etc. Psychiatric symptoms could be reduced by treatment. Almost all patients are referred to psychiatric intervention in our hospital. However, a number of patients show non-adherence. The aim of this study is to figure out the reason of non-adherence and psychiatric symptoms of work related burns patients. METHODS: 123 patients participated in this study. Startle, Physiological arousal, Anger, and Numbness (SPAN), Feeling Suicide, Patient Health Questionnaire-2 (PHQ-2) were administered as screening tool. Questions about psychiatric intervention and reasons to refuse psychiatric intervention were asked. RESULTS: 32% patients were depressed, 34% patients had suicide ideation and 59% had PTSD after work related burns. However, 46% of burn patients had not been treated. Stigma of psychiatric intervention and concerns about dependency were major reasons for non-adherence. CONCLUSION: There are gap between necessity and reality of psychiatric intervention on work related burn patients.
Anger ; Anxiety ; Arousal ; Burns ; Dependency (Psychology) ; Depression ; Humans ; Hypesthesia ; Mass Screening ; Occupational Injuries ; Referral and Consultation ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Suicide

OBJECTIVE: This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. METHODS: This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. RESULTS: Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. CONCLUSION: The current prevalence rate of partial and full PTSD rapidly decreased during 3 years.
Follow-Up Studies* ; Korea ; Prevalence ; Stress Disorders, Post-Traumatic*

Glucokinase is expressed only in both liver and pancreatic beta cells and has a key role in the regulation of glucose metabolism in these tissues. A number of gene defects associated with glucokinase gene and the cause of non-insulin-dependent diabetes mellitus are known, and the defects along the -30bp promoter site in particular are thought to be related to diabetes and glucose intolerance. To research on gene study related to diabetes, we looked into the relationship between the variation at -30bp of pancreatic beta cell specific glucokinase gene promoter and gestational diabetes mellitus(GDM) in Korea. METHODS: Forty patients with GDM and 62 normal controls were studied. Genomic DNA was extracted from peripheral leukocyte of patients with GDM and normal controls. The nucleotide variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter was analyzed by PCR-SSCP methods. The sequences of amplified DNA were confirmed with direct sequencing method. The clinical features and the response of insulin secretion to oral glucose were analyzed between patients with GDM according to genotypes. RESULTS: Allelic frequency of position -30 bp of pancreatic beta cell specific glucokinase gene promoter did not differ between patients with GDM and normal subjects. However the frequency of G/A and A/A genotypes seemed to show a higher tendency in patients with GDM compare to the normal subjects. Clinical features, insulin response to oral glucose did not differ according to the type of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter. CONCLUSION: These data suggested that the variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter in patients with GDM are unlikely to be one of the possibilities of the genetic factors in the development of GDM. Therefore more sophisticated studies will be needed to elucidate the role of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter in the insulin secretion to oral glucose.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; DNA ; Female ; Genotype ; Glucokinase* ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Insulin-Secreting Cells ; Korea ; Leukocytes ; Liver ; Metabolism ; Pregnancy

Glucokinase is expressed only in both liver and pancreatic beta cells and has a key role in the regulation of glucose metabolism in these tissues. A number of gene defects associated with glucokinase gene and the cause of non-insulin-dependent diabetes mellitus are known, and the defects along the -30bp promoter site in particular are thought to be related to diabetes and glucose intolerance. To research on gene study related to diabetes, we looked into the relationship between the variation at -30bp of pancreatic beta cell specific glucokinase gene promoter and gestational diabetes mellitus(GDM) in Korea. METHODS: Forty patients with GDM and 62 normal controls were studied. Genomic DNA was extracted from peripheral leukocyte of patients with GDM and normal controls. The nucleotide variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter was analyzed by PCR-SSCP methods. The sequences of amplified DNA were confirmed with direct sequencing method. The clinical features and the response of insulin secretion to oral glucose were analyzed between patients with GDM according to genotypes. RESULTS: Allelic frequency of position -30 bp of pancreatic beta cell specific glucokinase gene promoter did not differ between patients with GDM and normal subjects. However the frequency of G/A and A/A genotypes seemed to show a higher tendency in patients with GDM compare to the normal subjects. Clinical features, insulin response to oral glucose did not differ according to the type of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter. CONCLUSION: These data suggested that the variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter in patients with GDM are unlikely to be one of the possibilities of the genetic factors in the development of GDM. Therefore more sophisticated studies will be needed to elucidate the role of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter in the insulin secretion to oral glucose.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; DNA ; Female ; Genotype ; Glucokinase* ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Insulin-Secreting Cells ; Korea ; Leukocytes ; Liver ; Metabolism ; Pregnancy