PURPOSE: Intussusception is a very common pediatric problem and needs early management. This study evaluated the risk factors of intussusception in infants and children for early diagnosis and treatment. METHODS: 216 cases of pediatric intussusception occurring between 1993 and 1999 in Mokpo Catholic Hospital were investigated retrospectively. 164 patients treated with barium reduction comprised the barium reduction (BR) group and 52 patients treated with manual reduction or bowel resection was operation (OP) group. RESULTS: The age incidence under 1 year old was 108 patients (65.9%) in BR group, 45 patients (86.5%) in OP group. Male to female ratio was 1.8:1 in BR and 1.7:1 in OP, respectively. In the seasonal distribution spring was more common in both group (34.1%, 34.6%). 60.4% in BR group, 76.9% in OP group were revealed leukocytosis above 10.000/mm3 in serum. Previous combined diseases were upper respiratory infection (31.7%, 42.3%), acute gastroenteritis (1.2%, 1.9%) and multiple familial polyposis (0.5% in BR group). The frequent symptoms and signs were bloody stool (86.0%,92.3%), abdominal pain and irritability (86.6%, 82.7%), vomiting (76.9%, 67.3%), and abdominal mass (56.7%, 76.9%). Tachycardia was 12.2% in BR and 44.2% in OP. In plain abdominal radiography, intestinal obstructive pattern was present in 5.5% of BR group and 53.8% of OP group. Success rate of barium reduction within 24 hours after symptom appearance was 82.3%. Within 24-48 hours was 61.1%, above 48 hours was 25%. There was a statistically significant difference between BR group and OP group of patients under 1 year old, with tachycardia, symptoms for longer than 48 hours and obstructive pattern on plain abdominal radiography (p<0.05). Of surgical cases, 84.6% were idiopathic. The common anatomical type was ileo-colic type (53.9%). The methods of operation were manual reduction (94.2%) and bowel resection (5.8%). Postoperative complications occurred in 4 cases; 3 cases of wound infection and 1 case of pulmonary complication. Recurrence rate was 12.8% in BR group. CONCLUSION: Risk factors of high incidence such as under 1 year old, severe obstructive pattern on the plain abdominal radiograph, symptoms for longer than 48 hours, and tachycardia, were related with a low success rate of barium reduction. Therefore, a gentle barium enema is recommended in high risk patients for diagnosis and prompt surgical intervention.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastroenteritis ; Humans ; Incidence ; Infant* ; Intussusception* ; Jeollanam-do ; Leukocytosis ; Male ; Postoperative Complications ; Radiography, Abdominal ; Recurrence ; Retrospective Studies ; Risk Factors ; Seasons ; Tachycardia ; Vomiting ; Wound Infection

Treatment of oral cancers with chemotherapeutic agents are evaluated as an effective method for remission to reduce cancer proliferation nowadays. But, minimization of side-effects such as bone marrow suppression, gastrointestinal toxicity and renal damage is another problem to be solved. Thus, a possible approach to develop a clinically applicable chemotherapeutic agents is to screen anticancer activity among traditional medicinal plants which have been used for thousands of years with very low side-effects in orient. In this study we focused on screening anti-oral cancer activities among 14 traditional medicinal plant extracts that revealed anticancer activities on other solid tumors. The results were as follow: 1. Methanol extract of Lepidium apetalum showed the highest anti-oral cancer activity against A253 cells. At concentration of 4 microgram/ml, the cell viability was 48% under our experimental condition. IC50 value obtained was 4 microgram/ml. 2. Methanol extract of Coptis japonica and Solanum nigrum were effective on KB cells. Cell viability observed were 62% and 67% at concentration of 4 microgram/ml, and IC50 values were 12 microgram/ml and 10 microgram/ml respectively. 3. When the methanol extract of Lonicera caerule was combined with 2 microgram/ml of cisplatin, the anticancer activity was synergistically increased. One hundred microgram/ml of Lonicera caerule showed 92% (alone) or 59% (combined with cisplatin) cell viabilities. IC50 value of Lonicera caerule extract against KB cells was reduced from 301 microgram/ml to 126 microgram/ml when combined with 2 microgram/ml of cisplatin. 4. Medicinal plant extracts effective on both A253 and KB cells were Coptis japonica, Lepidium apetalum, Solanum nigrum, Caesalpiniae Lignum, Curcuma aromatica.
Bone Marrow ; Caesalpinia ; Cell Survival ; Cisplatin ; Coptis ; Curcuma ; Humans ; Inhibitory Concentration 50 ; KB Cells ; Lepidium ; Lonicera ; Mass Screening ; Methanol ; Mouth Neoplasms ; Plants, Medicinal* ; Solanum nigrum

The Na+ -K+ -activated ATPase is required to maintain osmotic balance and stabilize cell volume. The Na+ -K+ -ATPase has a more direct role in regulating cell volume; it controls the solute concentrations inside the cell, thereby regulating the osmotic forces that can make a cell swell or shrink. The impotance of the Na+ -K+ -ATPase in controlling cell volume is indicated by the observation that animal cells swell, and may burst, if they are treated with ouabain, which, inhibits the Na+ -K+ -ATPase. The present experiment was designed and carried out to determine the effect of verapamil, a calcium blocker, on the activity of Na+ -K+ -ATPase prepared from renal medulla in the normal rabbit. It was reported that verapamil, a well known coronary vasodilator, possessed negative inotropic effects. The mechanism of action of verapamil was initially thought to be due to coronary vasodilation and blockade of myocardial B-adrenergic receptors. 1t was termed such agent calcium antagonist. A derivative of verapamil, D-600, was subsequently shown to block the movement of calcium through the slow channel and thereby after the plateau phase of the cardiac action potential. Verapamil do not directly antagonize the effects of calcium. Rather, it inhibit the entry of ealcium into cells or its mobilization form intracellular stores and, as such, have been termed a calcium channel blocker.
Action Potentials ; Adenosine Triphosphatases* ; Adenosine* ; Animals ; Calcium ; Calcium Channels ; Cell Size ; Gallopamil ; Ouabain ; Vasodilation ; Verapamil*

PURPOSE: Rupture of pre-existing cerebral aneurysms has been reported as a cause of traumatic subarachnoid hemorrhage (TSAH). SAH due to rupture of pre-existing cerebral aneurysm is an important differential diagnosis in TSAH. Our study was aimed to assess whether a rupture in a pre-existing cerebral aneurysm could be predicted on the basis of the quantity and distribution pattern of hemorrhage on the initial computed tomography (CT). METHODS: 197 patients with TSAH were retrospectively studied between the years 2003 and 2008. We examined the age and sex of patients, mechanisms of injury, consciousness level at admission, and CT parameters including the distribution and quantity of SAH, localized blood clot, intraventricular hemorrhage, or hemorrhagic contusion and extra-axial hematoma. We compared the patients with nonaneurysmal TSAH to the patients with aneurysmal TSAH. RESULTS: 22(11.2%) patients with TSAH harbored pre-existing cerebral saccular aneurysms. The aneurysms were found in the patients with diffuse or anteriorly located blood in the basal cisterns(40.6%), unilateral sylvian fissure (16.7%), and anterior interhemispheric fissure(18.2%). But the aneurysm was not found in all patients with perimesencephalic hemorrhage, bilateral sylvian fissures, and convexities. TSAH with localized clot in the anterior interhemispheric or sylvian fissure (OR=5.924, p=0.005), or SAH completely filling any cistern or fissure (OR=3.148, p=0.034) was significantly associated with rupture of pre-existing cerebral aneurysm in logistic regression analysis. CONCLUSION: SAH in the basal cisterns extended into bilateral sylvian fissures and anterior interhemispheric fissure, and SAH in the unilteral sylvian fissure on initial CT could be predicted rupture of pre-existing cerebral aneurysm.
Aneurysm ; Consciousness ; Contusions ; Craniocerebral Trauma ; Diagnosis, Differential ; Head ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Logistic Models ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic ; Tomography, X-Ray Computed

OBJECTIVE: Rubella viral infection in pregnant women is frequently transmitted to the fetus, resulting in the fetal damage. The incidence of rubella infection has decreased due to a nation-wide rubella vaccination program, but, vulnerability to rubella infection has been detected in 10-20% by serology test. The purpose of this study is to assess the rubella specific immune status of a group of reproductive ages. METHODS: The seroprevalence of rubella was determined in the study group that consists of 430 university girl students (ages 19-23 years). Rubella specific IgG antibody titer of the girl's sera was checked by enzyme immunoassay. And we questioned about the knowledge of rubella infection and wanted age for marriage. RESULTS: According to our study, the seropositivity rate of the women was 73.0% for rubella. And mean IgG antibody titer was 67.09 +/- 57.75 IU/mL. There was no significant difference between immunized groups during highschool students and others. Nine girls had natural immunity from rubella infection and they all had positive IgG antibody titers. And there were no statistical differences of IgG positive rate according to age. CONCLUSION: With such a high susceptible density of reproductive women, vaccination against rubella should be enforced more actively in order to prevent possible outbreaks of the congenital rubella syndrome, especially in reproductive women. And education about rubella infection, immunity and pregnancy outcome after rubella infection should be enforced.
Disease Outbreaks ; Education ; Female ; Fetus ; Humans ; Immunity, Innate ; Immunoenzyme Techniques ; Immunoglobulin G ; Incidence ; Marriage ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Rubella Syndrome, Congenital ; Rubella* ; Seroepidemiologic Studies* ; Vaccination

BACKGROUND: The speed of injection of local anesthetic solutions into the subarachnoid space may influence the spread of these agents in the cerebrospinal fluid by the amount of turbulence generated, especially with large volume. To determine the proper injection speed of anesthetics in hypobaric spinal anesthesia on jack-knife position, the anesthetic level and duration were measured with the fast or slow injection speed. METHODS: Twenty patients for perianal surgery in jack-knife position under hypobaric spinal anesthesia were randomly assigned to one of two groups. Tetracaine (0.1%) in distilled water 5 ml was administered to all the patients. Group I patients received the drug with the speed of injection as 5 ml/20 sec (15 ml/min) and the others (Group II) as 5 ml/4 min (1.25 ml/min). The mean arterial pressures and heart rates at the preanesthetic period, and 5, 10, 15 and 20 min after the end of injection were measured. The anesthetic levels at 5, 10, 15 and 20 min after the injection and anesthesia duration were measured. RESULTS: There was no significant difference in mean arterial pressures, heart rates and anesthetic duration between two groups. The anesthetic level 20 min after the injection was higher in Group I than Group II, and not different at the other time sequences. CONCLUSION: At the injection speed within 1.25-15 ml/min in hypobaric spinal anesthesia on jack-knife position at 15o head-down, we acquired appropriate anesthetic level and duration for perianal surgery without any undesirable effects.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Arterial Pressure ; Cerebrospinal Fluid ; Head-Down Tilt* ; Heart Rate ; Humans ; Subarachnoid Space ; Tetracaine* ; Water

PURPOSE: Despite the increased number of patients visiting emergency rooms on weekends, the level of staffing is often lower than it is on weekdays. It is uncertain whether in-hospital mortality rates among patients depend on when they visited the hospital on a weekend or on a weekday. METHODS: We analyzed 21,645 patients who visited our emergency department in 2003. We compared death within 48 hours after a visit to the emergency room between patients who visited on weekends and those with visited on weekdays. The odds of death within 48 hours for patients who visited on a weekend were analyzed by using a multivariate logistic regression. The severity of illness was adjusted by using triage and the Charlson comorbidity score. RESULTS: Compared with patients who visited on weekdays, the number of patients who visited on weekends was increased in 30%. The mortality rates were not statistically different for patients who visited on weekends and patients who visited on weekdays (3.1% vs 2.8%, p=0.399). However, two diagnoses (pneumonia and spontaneous subarachnoid hemorrhage) were associated significantly with a weekend effect. CONCLUSION: Visiting the emergency department on weekends was not associated with a higher mortality than visiting the emergency department on weekdays.
Comorbidity ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Hospital Mortality ; Humans ; Logistic Models ; Mortality ; Prognosis* ; Triage

BACKGROUND: Herpes zoster is a significant and troublesome disease. The pain of acute herpes zoster may be severe, but is usually transitory. Some patients, especially the elderly at particular risk, go on to develop neuralgia. Unfortunately, neuralgia is often severe and refractory to most forms of treatment. The purpose of this study was to estimate improved rates of neuralgia according to associated factors. METHODS: We observed the improved rates of neuralgia in 123 patients who had herpes zoster with severe pain and treated with antiviral therapy after admission. Also, we compared them by age group, dermatomal distribution, and initiating day of antiviral therapy. RESULTS: At 4 weeks of treatment, the improved rates of neuralgia according to age younger group was high and older group was low. The improved rates of neuralgia according to the starting day of treatment was high 100% in 1 day, 76.5% in 2, 65.0% in 3days, and 18.2% in 7 days after skin eruption. CONCLUSION: In herpes zoster with severe pain, age and initiation of antiviral therapy are significant predictors of neuralgia.
Aged ; Herpes Zoster* ; Humans ; Neuralgia ; Neuralgia, Postherpetic* ; Skin

Post-traumatic intestinal stenosis (PIS) is an uncommon sequela of blunt abdominal trauma, in which injury to the mesentery or bowel wall leads to focal ischemic stricture of that segment. We present a case of PIS of the ileum diagnosed on the basis of radiological studies and surgical and pathologic findings in a patient with partial small bowel obstruction occurring five weeks after blunt abdominal trauma.
Constriction, Pathologic* ; Humans ; Ileum ; Mesentery

INTRODUCTION: This study examined the anatomical morphology of the medial surface of the posterior mandible using 3-dimensional cone-beam computed tomography (CT) images to reduce the number of complications related to dental implant placement. MATERIALS AND METHODS: Fifty patients were enrolled in this study with an average age (+/-standard deviation) of 44.28 (+/-13.05). On the coronal views cone-beam CT of the first molars, the distance between the top of the canal and alveolar crest vertical distance (VD), the distance between the upper-most point of the canal and the point perpendicular to the lingual cortical margin of the mandible lingual distance (LD), the location of the starting point of VD for reducing from the vertical reference line (VD point), and the inclination of the mandibular medial surface (lingual inclination) were measured, and a statistical evaluation was performed using SPSS for Windows version 15.0. RESULTS: The mean VD0 was 16.91+/-2.47 mm and VDx decreased with increasing x value. The mean LD was 5.27+/-1.36 mm. The VD began to decrease at the mean location of 6.12+/-0.96 mm from the vertical reference line. The mean lingual inclination was 1.52+/-0.72degrees. CONCLUSION: These results will assist in the accurate placement of dental implants and the reduction of complications, particularly in the case of preoperative implant planning using only 2-dimensional imaging methods. (ex. panoramic radiography)
Cone-Beam Computed Tomography ; Dental Implants ; Humans ; Mandible ; Molar