Objective: Menstruation is a great part as the procedure for physiological, psychological development and physical growth, and menstrual disorders are very common problems in adolescence period. these problems can be resolved by interview or appropriate education of normal pubertal development. However unlike other developed countries, systematic report or appropriate education for menstruation may not be performed in our country. Therefore. our pediatric department investigated for menstruation of normal pubertal age women as an information educating adolescence. Methods: In cross-sectional study (ex, questionnaire), 4112 junior high and high school girl students (12~18 years old) in Ansan, Kyungki-do were investigated for menarcheal age, menstrual cycle, duration, amount, premenstrual syndrome, dysmenorrhea and relation to family history. Resulta: 1) Mean Menarcheal age was 12.9+/-1.2 years. According to menarcheal age by present age, menarcheal age was younger when present age was young as menarcheal age 11.8+/-0.6 years at 12 years, 13.3+/-1.1 years at 16 years, and 13.7+/-1.1 years at 18 years, respectively (p<0.001). 2) The month during which menarche occurs most frequently was August (14.7%), followed by July, December and January. 3) Considering menstrual cycle, mixed type (regular and irregular cycle) was most common (39.0%), and menstrual cycle became regular after mean 8.8+/-8.4 months. 4) In women having regular menstrual cycle, most women (53.l0%) had menstrual cycles between 26 and 30 days, next was 21~25 days and 31~35 days according to frequency. 5) Menstrual duration was 5~6 days by 49.6% of the women. 6) Premenstrual syndrome was noted in 56.0% of the women, in that 42.5% experienced occasionally and 13.5% always, respectively. 7) Dysmenorrhea was showed in 85.0% of the women. A total of 63.7% of the respondents suffered from dysmenorrhea was unaffected on daily activity as grade l and was needed no medication to relieve pain. Grade 2 (20.5%) was defined that limited daily activity and was needed medication to relieve pain. Grade 3 (0.9%) was defined that inhibited daily activity seriously, and was unimproved by analgesics. 8) The prevalence of dysmenorrhea was 78.0% at 12 years, 85.9% at 15 years and 94.0% at 18 years, respectively. Getting older, frequency of dysmenorrhea was increasing. 9) Dysmenorrhea was experienced for the first time during the first year after the menarche by 65.3% of the women. The amount of menstrual bleeding was significantly correlated to the severity of dysmenorrhea (P<0.001), and dysmenorrhea reported by the women was singificantly correlated to maternal dysmenorrhea (p<0.01) and to sisters with dysmenorrhea (p<0.001). Conclusions: We found that Korean adolescent girls had earlier menarcheal age than past period, and they had many problems for menstruation. This study suggested that it may be needed adolescent education and appropriate treatment of menstrual disorders.
Adolescent ; Analgesics ; Cross-Sectional Studies ; Surveys and Questionnaires ; Developed Countries ; Dysmenorrhea ; Education ; Female ; Female* ; Gyeonggi-do* ; Hemorrhage ; Humans ; Menarche ; Menstrual Cycle ; Menstruation* ; Premenstrual Syndrome ; Prevalence ; Siblings

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

A malignant rhabdoid tumor of the kidney, an uncommon renal tumor of children, is one of the most lethal neoplasms in early life. It was considered to be a sarcomatous variant of Wilms' tumor; however, further studies of its histological and clinical characteristics have proven it to be a distinct entity. We report a case of malignant rhabdoid tumor of the kidney in a 3-month-old girl, with a left abdominal palpable mass that had developed over the previous month. A left radical nephrectomy, with a regional lymph node biopsy, and 4 cycles of adjuvant chemotherapy, was performed. On the 45th postoperative day, multiple metastasises in liver, contralateral kidney and left upper lobe of lung were found. The patient expired 2 months after the operation.
Biopsy ; Chemotherapy, Adjuvant ; Child ; Female ; Humans ; Infant* ; Kidney* ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Nephrectomy ; Rhabdoid Tumor* ; Wilms Tumor

BACKGROUND: Tracheal intubation and skin incision are potent stimuli that can induce increased sympathetic activity, tachycardia and hypertension. The purpose of this study is to evaluate whether the epidural clonidine pretreatment reduce the sympathetic activity and cardiovascular response. We compared the hemodynamic changes and catecholamine concentration before, during and after general anesthesia with epidural clonidine pretreatment. METHODS: Forty patients undergoing lower abdominal surgery were randomly allocated into the two groups. In Group 1, 10 ml of 0.9% normal saline was administered epidurally 15 minutes before induction of anesthesia as control. In Group 2, 3 microgram/kg clonidine diluted in 10 ml normal saline was administered epidurally 15 minutes before induction of anesthesia. We measured the blood pressure, heart rate and plasma catecholamine concentration at preinduction, 1 minute after intubation (T1), 1 (T2) and 30 minutes after skin incision (T3), 1 (T4) and 2 (T5) hours after arrival at recovery room and the results were compared between group 1 and group 2. RESULTS: There was statistically significant difference in systolic pressure at T1 and T2 between the two groups. Heart rate was statistically significant difference at T1 and T4 between the two groups. There was statistically significant difference in epinephrine and norepinephrine concentration at T1 and T2 between the two groups. CONCLUSION: The elevation of blood pressure, heart rate and plasma catecholamine concentration accompanying tracheal intubation and skin incision may be reduced by administration of epidural clonidine.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Clonidine* ; Epinephrine ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Intubation ; Norepinephrine ; Plasma* ; Recovery Room ; Skin ; Tachycardia

Rupture of the major airway by blunt chest trauma is uncommon. It can potentially cause serious complications, such as tension pneumothorax or cardiovascular injuries, with an overall mortality rate reaching up to 30%. The etiology of trauma includes fall-down, traffic accidents, cycling and child abuse. Dyspnea was the most common feature, followed by hemoptysis, air leak and chest pain. It is well known that dyspnea after chest trauma is due to accumulation of secretions in the airway, mucosal and cartilaginous injuries and associated parenchymal injuries. In cases of recurrent dyspnea in children irrespective of trauma, we should consider asthma, foreign body aspiration, tracheal stenosis, bronchial tumor, mediastinal tumor, gastroesophageal reflux disease and vascular ring. In this case, we found granulation tissue repeatedly causing obstruction of the airway at the site of rupture after traffic accident. Dyspnea resolved after surgical resection of the granulation tissue. We report a case of recurrent granulation tissue showing dyspnea after bronchial rupture.
Accidents, Traffic ; Asthma ; Chest Pain ; Child ; Child Abuse ; Dyspnea ; Foreign Bodies ; Gastroesophageal Reflux ; Granulation Tissue ; Hemoptysis ; Humans ; Pneumothorax ; Rupture ; Thorax ; Tracheal Stenosis

BACKGROUND: The effective ventricular function during ejection and filling is likely to depend on the coordinated action of the longitudinally and circumferentially orientated myocardial fibers and the function of these longitudinal fibers has not been extensively studied. METHODS: The role of longitudinally and circumferentially orientated fibers in left ventricular wall motion was evaluated by M-mode echocardiograms of the mitral ring(whose motion reflect long axis change) and the standard minor axis(left ventricular posterior wall), simultaneous recordings of phonocardiograms and electrocardiograms on the paper (speed 100mm/sec), in 24 healty individuals, 17 patients with mitral stenosis, 11 patients with open mitral commissurotomy and 17 mitral valve replaced patients. RESULTS: In the controls long axis shortening significantly preceded minor axis shortening (phase difference between two axes : 20+/-3 msec, mean+/-SEM) during early systole, indicating left ventricle become more spherical. This phase difference was also observed in the patients with mitral stenosis and in those with open mitral commissurotomy. In patients with mitral valve replacement(MVR) whose papillary muscles had been sectioned, the onset of long axis shortening was more delayed during early systole than that of short axis(-33+/-6msec) and the end of shortening was also prolonged to early diastole more than that of normal controls (54+/-3 msec vs 90+/-8 msec, mean+/-SEM, p<0.01 by t-test). CONCLUSION: We observed the time relations between long and short axis motion in normal controls. It can be concluded that the reversed time relation in patients with MVR is one of the important factors which may effect negatively on ventricular function and long-term prognosis, thus the surgical procedures to preserve papillary annular continuity should be considered in patients with mitral valvular disease. And the controlled, prospective, clinical trials with homogenous groups of patients are needed to evaluate the potential benefits of papillary annular continuity in preserving atrio-ventricular interaction in patients undergoing mitral valvular surgery.
Axis, Cervical Vertebra* ; Diastole ; Echocardiography ; Electrocardiography ; Heart Valve Diseases* ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Papillary Muscles ; Prognosis ; Systole ; Ventricular Function

BACKGROUND: The objective of the present study was to evaluate whether left ventricular diastolic function is altered in rheumatoid arthritis. METHODS: Thirty-six patients of rheumatoid arthritis diagnosed by 1988 revised criteria for rheumatoid arthritis and 20 cases of normal control group were matched with respect to left ventricular ejection fraction and diastolic parameters. RESULTS: Parameters of diastolic function such as peak filling rate, time to peak fillling rate and 1/3 filling rate were not significantly different between patients with rheumatoid arthritis and control groups. although time to peak filling rate was significantly prolonged in seropositive group(p<0.05). CONCLUSION: Left ventricular diastolic function is notes not to be impaired in patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Humans ; Stroke Volume

Familial adenomatous polyposis(FAP) is a rare hereditary disorder characterized by the development of hundreds to thounds polyps throughout the colon and rectum. Moreover, several extracolonic manifestations are seen. Recently, this disease is recognized as a adenomatous polyposis syndrome which can involve the entire astrointestinal tract. Several reports have demonstrated a high incidence of gastroduodenal polyps in patients with familial adenomatous polyposis. These colon polyps can be eventually developed as colon cancer, if not be treated. So early diagnosis is needed and prophylactic surgery should be erformed. We experienced a case of familial adenomatous polyposis with a large sentinel polyp on the sigmoid colon, presenting hematochezia and mucoid diarrhea. He was early treated before progression to carcinoma by total colectomy, rectal mucosectomy and J pouch ileoanal anastomosis.
Adenomatous Polyposis Coli* ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Pouches ; Diarrhea ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Polyps* ; Rectum

Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumors are extremely rare, and only 56 cases have been reported in the literature. Because of the rarity of the lesion, its histogenesis and prognosis are unclear. Here we report a case of a primary renal carcinoid tumor in a 51-year-old man that was found incidentally in a medical examination and was treated by transperitoneal radical nephrectomy.
Carcinoid Tumor ; Humans ; Kidney ; Middle Aged ; Nephrectomy ; Neuroendocrine Cells ; Prognosis

PURPOSE: We studied to investigate the minimum concentration and preservation time of ethanol for sterilization of donor sclera. METHODS: Fresh sclera was inoculated with Staphylococcus epidermidis(ATCC 155), Staphylococcus aureus(ATCC 28213), Pseudomonas aeruginosa(ATCC 27843), and transferred to preservative vials containing the concentration of ethanol(10, 30, 50, 70, and 90%) or trypticase soy broth(TSB, control) and stored at room temperature. The sclera was then homogenized, plated on blood agar, and incubated at 37 degreesC for 24 hours. Colonies were counted at 6, 12, 24, 48, and 72 hours. RESULTS: Staphylococcus epidermidis and Staphylococcus aureus were recovered from contaminated sclera plates preserved in 10% ethanol until 72 hours and in 30% ethanol until 12 hours, but no bacteria was recovered from the sclera preserved in more than 50% ethanol(P<0.05). Pseudomonas aeruginosa was recovered in 10% ethanol until 72 hours but not recovered in more than 30% ethanol until 24 hours(P<0.05). However, all three species were recovered from the control sclera preserved in TSB until 72 hours. CONCLUSIONS: From the above results it is concluded that the concentration of more than 50% ethanol for at least 6 hours is recommendable as human sclera disinfectants.
Agar ; Bacteria ; Disinfectants ; Ethanol* ; Humans ; Pseudomonas ; Pseudomonas aeruginosa ; Sclera* ; Staphylococcus ; Staphylococcus aureus ; Staphylococcus epidermidis ; Sterilization* ; Tissue Donors*