PURPOSE: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TRI) and normal brain MRI findings. MATERIALS AND METHODS: Thirty TBI patients and 19 healthy volunteers underwen1 rest/acerazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM97), RESULTS: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities, In patients with lower performance scale scores. CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a port of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal Iobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. CONCLUSION: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.
Adult ; Brain ; Brain Injuries* ; Frontal Lobe ; Healthy Volunteers ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Occipital Lobe ; Rabeprazole ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon

PURPOSE: The purpose of this study was to examine the effects of sensory stimulation on premature infants. METHOD: Thirty three premature infants admitted to NICU of D University Hospital in C city were randomly assigned in two groups (Experimental group: 16, Control group:17). For the experimental group, tactile and kinesthetic stimulation developed by Dr. Field was applied 2 times a day for 10 days. Behavioral state was measured using the Anderson Behavioral State Scale (ABSS). Heart rate, respiration, and oxygen saturation were obtained for each infant before and after sensory stimulation. Hypothesis testing was done using the X2- test, student t-test, and repeated measures of ANOVA. Result: Hypothesis 1: There was a significant difference in the daily body weight gain between experimental and control group (F= 40.77, p= .0001). Hypothesis 2: There was a significant difference in the frequency of 'inactive awake state' between two groups (X2= 39.778, p= .001). Hypothesis 3: There were significant differences in the mean of heart rate and O2 saturation between two groups (t= -2.174, p= .037; t= 3.080, p= .005). However, there was no significant difference in the mean of respiration rate between two groups (t= -1.966, p= .581). CONCLUSION: The effectiveness of a sensory stimulation on weight gain and behavioral state in premature infants was supported. Further study is recommended to develop a sensory stimulation method as an independent nursing intervention for premature infant.
Body Weight ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Nursing ; Oxygen ; Respiration ; Respiratory Rate ; Weight Gain*

With the aim of establishing bio-indices for the development of multistep hepatotumorigenesis, rats were fed water containing 0.01% diethylnitrosamine (DEN) ad libitum for 13 weeks. This treatment with DEN only made it possible to induce hepatic tumors in 100%. After the DEN administration, several clinical symptoms were observed including minor behavioral changes, brittleness of hair and a decrease in water and food intake. The concentration of total serum protein and albumin in all treated groups was significantly lower than in non-treated controls (p<0.05). Increase of specific enzyme (AST, ALT and GGT) activity (p<0.05), variable tumor size and hepatomegaly of the liver was observed in all rats treated with DEN for 10 weeks. Both hepatocellular carcinoma and cholangiocarcinoma were found in the same livers at the same time, and were prominently developed after 12 weeks. In case of carcinoma, some of the livers showed more or less advanced states over the 12-15 weeks period. In the present study, hepatocellular carcinoma was developed by treating DEN in only the drinking water, without any other carcinogens or without partial hepatectomy. These results indicate that DEN is a new carcinogen that acts directly on it the liver, moreover, it might be very useful for investigating hepatotumorigenesis.
Alanine Transaminase/blood ; Animals ; Aspartate Aminotransferases/blood ; Biological Markers/blood ; Carcinogens ; *Cell Transformation, Neoplastic ; Diethylnitrosamine/toxicity ; Liver/drug effects/*pathology ; Liver Neoplasms/blood/chemically induced/*pathology ; Liver Neoplasms, Experimental/blood/*pathology ; Male ; Rats ; Rats, Sprague-Dawley ; gamma-Glutamyltransferase/blood

PURPOSE: The purposes of the study were to develop and test a model which explains the relationship among factors affecting behavioral problems in elementary school children. METHODS: The participants for the study were 368 elementary school children and their mothers at 3 elementary schools in one city. Data analysis was done using the SPSS 17.0 program for t-test, -test, and ANOVA and the AMOS 17.0 program for theoretical model testing. RESULTS: The theoretical model showed a significant goodness of fit to the empirical data (Goodness of Fit Index: .96, Adjusted Goodness of Fit Index: .93 Comparative Fit Index: .95, Root Mean Square Error of Approximation: .06, Standardized Root Mean Square Residual: .02). Six paths were found to be statistically significant including from child rearing attitude to self-esteem, stress, stress coping and behavioral problems, and from self-esteem to stress and behavioral problems. Child rearing attitude showed a significant effect to behavioral problems by total effect. Self-esteem affected behavioral problems by total and direct effects. CONCLUSION: Child rearing attitude and self-esteem of children are important factors affecting behavioral problems in elementary school children.
Adaptation, Psychological ; Child Behavior ; Child Rearing ; Child* ; Humans ; Models, Theoretical ; Mothers ; Parenting ; Self Concept ; Statistics as Topic

The aims of this study were to investigate the present status of skeletal maturation and to compare body composition parameters on the basis of the levels of skeletal maturity in boys aged 9 ~12 years. The subjects participated consisted of 258 elementary school boys. Anthropometric characteristics included body weight, height, sitting height, bone widths, circumferences, and skinfold thicknesses. Skeletal maturation was assessed by the Tanner -Whitehouse II method. Skeletal age was determined by RUS scores (radius, ulna, and short bones). Body composition variables were evaluated by bioelectrical impedance analysis (BIA Model 310). Means and standard deviations were calculated by descriptive statistics. To compare body composition variables among skeletal maturity groups one -way analysis of variance (ANOVA) was applied and Duncan's a posteriori tests. The results showed that RUS scores varied from 298.2 for 9 years to 482.6 for 12 years. TW2 -20 scores were 569.2 for 9 years, 628.8 for 10 years, 701.8 for 11 years, and 814.5 for 12 years. Skeletal ages were 9.7 for 9 years, 10.5 for 10 years, 11.7 for 11 years, and 13.6 for 12 years. It indicates that chronological age was lower than skeletal age in all age groups. Although no significant difference was found in 12 years for body composition according to the levels of skeletal maturity, in general advanced boys had higher body composition variables than retarded boys. In 9 years there were significant differences (p 0.05) among skeletal maturity groups for body mass index, WHR, and WTR. Also, differences were found in 10 years for percent body fat, fat -free mass, and body mass index. In 11 years advanced children (40.4 kg) have statistically significant (p 0.05) higher fat -free mass than retarded children (32.2 kg).
Adipose Tissue ; Body Composition* ; Body Mass Index ; Body Weight ; Child ; Electric Impedance ; Humans ; Skinfold Thickness ; Ulna

We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed.
Neck ; Neoplasm Metastasis ; Salivary Gland Calculi* ; Submandibular Gland ; Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.
Ligaments* ; Polytetrafluoroethylene*

PURPOSE: Airway eosinophilic inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: A total of 40 asthmatic children over 6 years of age were divided into two groups : Group A of 15 current symptomatic subjects and Group B of 25 stable asymptomatic subjects with history of asthma for 2 weeks. Eosinophils in induced sputum were compared with the severity of asthma symptom, pulmonary function, bronchial hyperresponsiveness by methacholine, sputum ECP, blood eosinophils and serum ECP. RESULTS: 1) Asthmatics had a significantly higher proportion of sputum eosinophils than the control subjects (15.2+/-17.8% VS 3.8+/-4.5%, P<0.01). Group A had a significantly higher proportion of sputum eosinophils than group B (22.9+/-21.7% VS 11.2+/-14.8%, P<0.05). 2) Sputum eosinophils were correlated with symptom scores in asthmatics (r=0.76, P<0.01), inversely correlated with FEV1 in group A (r=-0.65, P<0.01) and with LogPC20 in group B (r=-0.45, P<0.05). 3) Sputum eosinophils were correlated with sputum ECP for group A; r=0.77 (P<0.01) and for group B; r=0.39 (P<0.05) but not correlated with serum ECP. 4) Sputum eosinophils were correlated with blood eosinophils in group A (r=0.67, P<0.05), but not in group B. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with blood eosinophils or serum ECP are to be studied further.
Asthma* ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Sputum*

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.
Caregivers ; Empathy ; Humans ; Morals ; Pain Management* ; Seoul ; Students, Nursing

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection