Since clinical significance of blood pressure level in childhood has been known, a several studies for the purpose of establishing normal blood pressure referece values in Korean school-aged children were performed. The author of this article measured normal blood pressure values for children in an elementary school, and two middle schools of Korean rural area using mercury sphygmomanometer. The results were as follows: 1) Systolic and diastolic blood pressure values increased according as age and height increased. Abrupt increase in systolic and diastolic blood pressure values at 11 years of age in both sexes was observed. 2) Average values of systolic/diastolic blood pressure in 6 year-old boys were 106/61 mmHg and these values increased with rates of 1.5 mmHg/yr (systolic blood pressure), 1.0 mmHg/yr (diastolic blood pressure). Similarily, the values in 6 year-old girls were 103/60 mmHg and they increased with the rate of 2.0 mmHg/yr (systolic blood pressure) and 1.5 mmHg/yr (diastolic blood pressure). 3) As the distribution of blood pressure level was observed in view of age and height reference, there were no biologically and statistically significant discrepancies in blood pressure level between boys and girls. 4) A strong positive correlationship with each parameters was observed in both sexes. 5) Blood pressure values for 50, 90, 95 percentile were presented in table and figure.
Blood Pressure* ; Child* ; Female ; Humans ; Korea ; Sphygmomanometers

BACKGROUND AND OBJECTIVES: The assessment of left ventricular (LV) diastolic function is important in chronic renal failure because abnormal LV diastolic function has been frequently described in patients on maintenance hemodialysis both during the dialysis and in the dialysis-free interval despite the normal LV systolic function. But the echocardiographic indexes of LV diastolic function is known to be affected by several factors such as loading condition, LV compliance and heart rate. The purpose of this study is to investigate the effect of hemodialysis on the echocardiographic indexes of left ventricular diastolic function in chronic renal failure. Materials AND METHODS: We examined transmitral flow velocity, pulmonary venous flow velocity, and mitral annulus velocity in 20 patients (15 men and 5 women, average 50+/-14, range 19-69 years) of chronic renal failure with normal LV systolic function by echocardiography before and after hemodialysis. RESULTS: 1)According to the body weight change (from 59.5+/-8.3 to 57.2+/-8.1 kg, p=0.0001), after hemodialysis, inferior vena cava dimension (from 18+/-4 to 13+/-5 cm, p=0.0001), left ventricular end-diastolic dimension (from 57+/-6 to 53+/-7 cm, p=0.0001), and left ventricular outflow tract (LVOT)-time velocity integral (TVI, from 26+/-5 to 23+/-5 cm, p=0.004), which reflect intravascular blood volume, decreased significantly. 2)The peak velocity of early transmitral flow (E, from 0.79+/-0.14 to 0.64+/-0.11 m/s, p=0.0001), the peak velocity of late transmitral flow (A, from 0.84+/-0.21 to 0.78+/-0.21 m/s, p=0.011), and E/A ratio (from 0.99+/-0.25 to 0.87+/-0.27, p=0.007) decreased significantly, and deceleration time (DT, from 241+/-48 to 267+/-59 ms, p=0.055) showed tendency of prolongation after hemodialysis. 3)Peak systolic velocity of pulmonary venous flow decreased significantly after hemodialysis (from 0.65+/-0.11 to 0.59+/-0.12 m/s, p=0.042). 4)The difference between duration of reversal flow of pulmonary vein and duration of transmitral flow during atrial contraction (ADD) did not change significantly after hemodialysis (from 5+/-31 to 1+/-29 ms, p=0.502), and did not correlate with the change of peak velocity of early transmitral flow during hemodialysis (DMVE, r=0.390, p=0.089). 5)The peak early diastolic velocity (Ean, from 0.07+/-0.02 to 0.06+/-0.02 m/s, p=0.002) and Ean/the peak late diastolic velocity (Aan) ratio (from 0.78+/-0.27 to 0.62+/-0.19, p=0.003) of medial annulus of mitral valve decreased significantly after hemodialysis. CONCLUSION: Hemodialysis, which reduces LV preload by fluid removal, changes the echocardiographic indexes of left ventricular diastolic function in chronic renal failure. Preload condition need to be accounted for when we evaluate the LV diastolic function with echocardiography.
Blood Volume ; Body Weight Changes ; Compliance ; Deceleration ; Dialysis ; Echocardiography* ; Female ; Heart Rate ; Humans ; Kidney Failure, Chronic* ; Male ; Mitral Valve ; Pulmonary Veins ; Renal Dialysis* ; Vena Cava, Inferior

The usefulness of E-cadherin immunostaining as a marker of malignancy in the body fluids was investigated in the present study. Thirty-three histologically proven cases of cell blocks from the pleural, peritoneal, and pericardial fluids were studied by immunocytochemistry for E-cadherin antibody using LSAB method. These cases were cytologically diagnosed as adenocarcinoma (25 cases) and atypical cells (8 cases). Tumor cells showed strong positive membranous staining for E-cadherin antibody in 21 out of 25 cases (84%) of adenocarcinoma. E-cadherin staining was not found in 6 of 8 cases of suspicious maligancy. The sensitivity and specificity were 84% and 75%, respectively. Reactive mesothelial cells and inflammatory cells scattered were all negative. In conclusion, E-cadherin is an useful adjunctive marker to distinguish reactive mesothelial cells from the carcinoma cells in the body fluids.
Sensitivity and Specificity ; Adenocarcinoma ; Neoplasm Metastasis

OBJECTIVES: Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. METHODS: Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. RESULTS: More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, p=8.2x10-7). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age(p=1.5x10(-3)) and NA score(p=1.5x10(-7)) were found to be statistically significant. CONCLUSIONS: The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.
Affective Symptoms ; Depression ; Depressive Disorder ; Heart Diseases ; Humans ; Linear Models

The bony spur formation without degenerative change in the lumbar spines in the young age group is quite interesting and not uncommon. This bony spur is different from the degenerative spur in the old age group in shape and mechanism of formation. The authors analyzed 111 patients with such posterior lumbar bony spur for recent 3 years and 9 months. The authors concluded that posterioly located Schmorl's node is a main cause of the bony spur without degenerative change at lumbar region. The authors advocated 'Juvenile spur' as a new disease entity.
Humans ; Lumbosacral Region ; Spine*

Myelodysplastic syndrome is a heterogeneous disease complex which is basically a clonal disorder and has characteristics of cytopenia of one or more cell series in peripheral blood and of dyspoiesis of precursors in bone marrow. Since the nature of this disease in childhood is very different from that in adults, retrospective clinical study was performed with 17 confirmed patients who were admitted to the Department of Pediatrics, Seoul National University Children's Hospital from June 1986 till October 1992. The results were as follows: 1) Themost frequent occurrence was found in preschool age group (76.5%), and male predominance was noted. 2) Hepatosplenomegaly was the most frequent clinical finding, and in view of laboratory findings, anemia waas found in all cases, and leukopenia in 5 cases, thrombocytopenia in 13cases were observed. Bone marrow aspiration revealed dyspoiesis of 3 cell series in almost all cases. The percentage of myeloblasts more than 5% of total bone marrow nucleated cells was seen in 8 cases on bone marrow study. 3) Subtypes of the disease were found to be 3 cases of RA, 6 cases of RAEB, 3 cases of RAEB-T, 4 cases of JCML, and 1 case of monosomy 7 syndrome. Chromosomal study was performed in 8 cases, and 6 of them were detected to be abnormal. 4) Supportive management was performed for almost all cases, and combined therapy with prednisolone and one-alpha for 3 cases, combined chemotherapy with various anticancer drugs for 7 cases, and low dose cytarabine therapy (10 mg/m2/12 hr) for 6 cases were performed. 5) There were 3 cases of drop out, 8 cases followed up on not remitted state, 5 cases of death, and 2 cases followed up on complete remission state. Two cases in complete remission were one of RA patients, and one of JCML patients, to whom prednisolone with one-alpha, and combined chemotherapy with A-Triple-V regimen were applied as treatment modalities, respectively. 6) Average duration of follow up for 10 survival cases was 18.2 months and a significant difference of 2 year survival rate was found in between the group composed of RA, RAEB and the other group composed of remained subtypes.
Adult ; Anemia ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; Child* ; Cytarabine ; Drug Therapy ; Follow-Up Studies ; Granulocyte Precursor Cells ; Humans ; Leukemia, Myeloid, Acute ; Leukopenia ; Male ; Monosomy ; Myelodysplastic Syndromes* ; Pediatrics ; Prednisolone ; Preleukemia ; Retrospective Studies ; Seoul ; Survival Rate ; Thrombocytopenia

BACKGROUND: Propafenone is effective in the treatment of ventricular arrhythmias and paroxysmal supraventricular tachycardia. Propafenone has been shown to be also useful in preventing the recurrence of atrial fibrillation. But to date, date concerning the efficacy of propafenone for patients experiencing paroxysmal and chronic atrial fibrillation have not been examined in Korea. METHODS: In patients with paroxysmal atrial fibrillation propafenone was given at a dose of 450mg daily without dose titration and symptomatic recurrences were evaluated by patient interview during follow-up. In patients with chronic atrial fibrillation, who had no previously attempted cardioversion, propafenone was given at a dose of 450~675mg daily without dose titration, and after a minimum of 3 days pharmacological cardioversion was assessed. Those patients in whom sinus rhythm had been restored pharmacologically or by combined direct current cardioversion were followed with maintaining propafenone therapy also at a dose of 450~675mg daily. RESULTS: Of 7 patients with paroxysmal atrial fibrillation, 4 (57%) patients had marked symptomatic improvement and they were followed for 197 to 460 (mean 286) days Of 13 patients with chronic atrial fibrillation, 7 patients incuding 4 pharmacologically converted patients were initially controlled to sinus rhythm. In 5 (38%) patients maintenance of sinus rhythm was followed for 90 to 415 (mean 224) days. CONCLUSION: Although these observations were made in small number of patients and are so limited, the results are comparable to the previous studies which showed the potential role of propafenone in the management of atrial fibrillation.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electric Countershock ; Follow-Up Studies ; Humans ; Korea ; Propafenone* ; Recurrence ; Tachycardia, Supraventricular

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

We report a case of tuberculosis verrucosa cutis in a 34-year-old male patient who presented with asymptomatic verrucous plaque over the right buttock, right inner thigh and right inguinal area. The Mantoux test revealed a strong positive reaction. The histologic picture consists of hyperkeratosis, acanthosis and papillomatosis overlying an inflammatory infiltrate in the upper dermis. Tuberculoid granulomas without caseation necrosis are seen in the dermis. Tubercle hacilli were not demonstrated. The patient was treated with INAH, Rifampicin and Ethambutol for 6 months. To date, the skin lesions have markedly improved.
Adult ; Buttocks ; Dermis ; Ethambutol ; Granuloma ; Humans ; Male ; Necrosis ; Papilloma ; Rifampin ; Skin ; Thigh ; Tuberculosis*

No abstract available.
Antioxidants* ; Glutathione* ; Humans