OBJECTIVES: The K-ARS(Korean ADHD Rating Scale) is one of the most important assessment tool of attentiondeficit hyperactivity disorder(ADHD) in Korea. In this study, we presented detailed normative data on the K-ARS for school-aged children in Seoul metropolitan area to put it to practical use. METHODS: The subjects were 2,397 students(1,223 boys and 1,174 girls, aged 6-12) from 4 elementary schools in Seoul, and one caretaker of each child completed the K-ARS for parents. Children who showed high scores of the KARS for parents were screened, and 2 child psychiatrists interviewed them to make a clinical diagnosis. We compared the mean scores of the K-ARS for parents between ADHD and normal group, and examined the percentage of correct classification. RESULTS: There were some differences in score of the K-ARS for parents according to sex and age, so we presented continuous normative data with T score and subdivided cut-off points for ADHD screening. Interviews with child psychiatrists using DSM-IV criteria were performed to test diagnostic validity, and the difference in every the K-ARS for parents index between ADHD and normal group was significant(p<.001). Using 3 different cut-off points(80th, 90th, 93rd percentage), the accuracies of ADHD correct classification were 67.9, 72.2, 71.1% and all 3 canonical discriminants were significant(p<.05) between ADHD and normal group. CONCLUSION: The normative data and cut-off points on the K-ARS for parents are useful in screening ADHD children in Seoul metropolitan area.
Child ; Classification ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea ; Mass Screening ; Parents* ; Psychiatry ; Seoul

We report a case of primary adenocarcinoma of the urethra in 62 years old female. Primary carcinoma of the female urethra is an uncommon malignancy that accounts for less than 0.02 per cent of all cancers occurring in women. Adenocarcinoma is rare in the literature. Whereas squamous cell carcinoma and transitional cell carcinoma, which comprise the majority of urethral malignancies, arise form the squamous or epithelial cells lining the urethra, adenocarcinoma arises form the periurethral glands.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Epithelial Cells ; Female* ; Humans ; Middle Aged ; Urethra*

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

A case of diffuse malignant mesothelioma of peritoneum which was difficult to distinguish from metastatic anaplastic carcinoma or malignant melanoma was presented. The patient was a 50 year-old woman and complained of an abdominal pain and ascites for 20 days. Histologically, the tumor cells showed highly anaplastic appearance with sheet-like arrangement without any papillary or tubular structure. They stained Positive for cytokeratin and vimentin and negative for CEA, S-100 protein and melanoma associated antigen. A few cells within the tumor showed Positive reactivity to desmin. Ultrastructurally, the tumor cells had characteristic findings of mesothelioma such as long, exuberant, wavy microvilli with 10 to 12 of length/diameter ratio. The patient died 3 months after the diagnosis in spite of intraperitoneal chemotherapy.
Female ; Humans ; Neoplasm Metastasis

Objectives: . To determine the appropriate anatomical borders of implantation on the temporal bone in a cadaver study, and to develop a simplified surgical technique for Baha Attract implantation through a small incision along the hairline using anatomical evidence and a navigation system. Methods: . In a cadaver study, 20 human adult dry skulls were used to find flat areas of the temporal bone for Baha Attract magnet implantation. Four borders of the “optimal surgical site” were defined: Asterion line, occipitomastoid suture line, sigmoid sinus line, and digastric groove line. In three patients, we implanted the Baha Attract according to the newly developed surgical procedure and validated the feasibility of this technique with a navigation system. Results: . We identified the appropriate position of the implant on the temporal bone, suggesting a simplified surgical technique for Baha Attract with a small incision. We determined the spot of implantation, and the implants were inserted through a small surgical incision (<2.5 cm) under local anesthesia; the procedure lasted approximately 30 minutes. Conclusion . The optimal surgical site of the temporal bone is a safe and easily accessible location for implantation of the Baha Attract.

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

OBJECTIVE: We retrospectively analyzed the surgical outcomes of 42 patients with growth hormone (GH)-secreting pituitary adenoma to evaluate the clinical manifestations and to determine which preoperative factors that significantly influence the remission. METHODS: Forty-two patients with GH-secreting pituitary adenoma underwent transsphenoidal surgery (TSS) between 1995 and 2007. The patient group included 23 women and 19 men, with a mean age of 40.2 (range 13-61) years, and a mean follow-up duration of 49.4 (range 3-178) months after the operation. For comparable radiological criteria, we classified parasellar growth into five grades according to the Knosp classification. We analyzed the surgical results of the patients according to the most recent stringent criteria for cure. RESULTS: The overall rate of endocrinological remission in the group of 42 patients after primary TSS was 64% (26 of 42). The remission rate was 67% (8 of 12) for microadenoma and 60% (18 of 30) for macroadenoma. The remission rate was 30% (3 of 10) for the group with cavernous sinus invasion and 72% (23 of 32) for the group with intact cavernous sinus. Cavernous sinus invasion in Knosp grade III and IV was significantly correlated with the remission rate. There was a significant relationship between preoperative mean GH concentration and early postoperative outcome, with most patients in remission having a lower preoperative GH concentration. CONCLUSION: TSS is thought to be an effective primary treatment for GH-secreting pituitary adenomas according to the most recent criteria of cure. Because the remission rate in cases with cavernous sinus invasion is very low, early detection of the tumor before it extends into the cavernous sinus and a long-term endocrinological and radiological follow-up are necessary in order to improve the remission rate of acromegaly.
Acromegaly ; Cavernous Sinus ; Female ; Follow-Up Studies ; Growth Hormone ; Growth Hormone-Secreting Pituitary Adenoma ; Humans ; Male ; Pituitary Neoplasms ; Remission Induction ; Retrospective Studies

PURPOSE: The purpose of this study was to help families decrease and alleviate the burden on family care-givers taking care of elderly patients. METHOD: Data was collected by a questionnaire from 100 family members who were registered in the department of home health care nursing at 4 hospitals of H University Medical Center from September 20 to October 25, 2005. The collected data was analyzed using Mean and Standard Deviation, Pearson Correlation Coefficient, t-test and One-Way ANOVA with the Duncan's test, and Stepwise multiple regression. RESULT: The average burden on family care-givers of elderly patients with chronic diseases was 3.31. The social burden was the highest(M=3.68), the lowest was the emotional burden (M=2.95). In ADL of elderly patients with chronic diseases, all 10 questions showed an average point above 2.50. The dependency level of going up and down the stairs was the highest (M=2.88). CONCLUSION: This research is necessary for the application of a plan in the social support system in order to reduce the burden on family care-givers who are taking care of elderly patients with a chronic disease.
*Activities of Daily Living ; Adult ; Aged ; Body Burden ; Caregivers/*psychology ; Chronic Disease/*nursing/psychology ; Cost of Illness ; Dependency (Psychology) ; *Family ; Female ; Humans ; Male ; Middle Aged ; Questionnaires ; Regression Analysis ; Social Behavior

PURPOSE: Viagra(sildenafil citrate) is a new oral medication that selectively inhibits phsphodiestarase-5(PDE5) in the corpus cavernosum to facilitate penile erection for the treatment for male impotence. We report a case of retinal hemorrhage associated with Viagra intake. METHOD: A 71-year-old male without known systemic disease visited with suddenly decreased visual acuity of 4 days duration in the Rt. eye. He intermittenly took 2 tablets of Viagra(50 mg) during 2 months and the symptom occurred 2 days after his last taking of Viagra. His corrected visual acuity was 0.3 in the Rt. eye and 1.0 in the Lt. eye. Several ophthalmologic examination was performed. RESULTS: Fundus exam revealed multiple dot hemorrhage with corresponding block fluorescence in the superior area of macula and superotemporal area of posterior pole. Inferonasal area visual field defect was detected by Goldmann perimetry and ERG finding was decreased maximal scotopic b wave ampitude. Ten weeks later, retinal hemorrhage was almost absorbed, but visual field defect and visual acuity did not improve.
Aged ; Erectile Dysfunction ; Fluorescence ; Hemorrhage ; Humans ; Male ; Penile Erection ; Retinal Hemorrhage* ; Retinaldehyde* ; Tablets ; Visual Acuity ; Visual Field Tests ; Visual Fields ; Sildenafil Citrate