PURPOSE: Kawasaki disease(KD) is known as one of the most important causes of acquired heart disease in children. But the incidence of acquired heart disease can be reduced by early diagnosis and treatment with large amounts of intravenous gamma-globulin(IVGG). For early diagnosis and treatment of atypical KD, we analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with typical or atypical KD. METHODS: A retrospective chart review was conducted in all children with Kawasaki disease who were admitted to the Department of Pediatrics of Kwang-Hye Hospital between January 1998 and December 1999. Except for 15 cases who were not followed, 62 cases were involved in this study. We analyzed and compared the clinical features, laboratory findings and coronary lesions in patients with 39 typical cases and 23 atypical cases of KD. RESULTS: The lowest incidence among clinical symptoms was cervical lymphadenopathy in both groups. In atypical cases, cervical lymphadenopathy, polymorphous exanthema, and changes of peripheral extremities were significantly lower than in typical cases. The duration of fever was similar in both groups, the mean defeverescence time after administration of IVGG in atypical cases was significantly shorter than typical cases(atypical, 2.6 days, typical cases, 1.8 days). The coronary artery dilatation appeared in 4 cases(17.4%) of atypical and 17 cases(43.6%) of the typical group. In most cases of both groups, left coronary artery dilatation was detected. CONCLUSION: To decrease the incidence of serious coronary complications due to atypical KD, careful evauation of clinical findings, early study of echocardiography and early infusion of large doses of IVGG are needed.
Child ; Coronary Vessels ; Dilatation ; Early Diagnosis ; Echocardiography ; Exanthema ; Extremities ; Fever ; Heart Diseases ; Humans ; Incidence ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Pediatrics ; Retrospective Studies

BACKGROUND: Bupivacaine is a amide type local anesthetic agent, widely used for its excellent quality of analgesia and long duration of action. But unintended intravenous injection causes severe complication such as convulsion and cardiovascular collapse, which is known for its difficulty in resuscitation. With all the study, the exact mechanism is still unclear and there are much debate on the method of resuscitation. METHOD: We studied the effect of clonidine pretreatment on bupivacaine-induced cardiac toxicity and resuscitation in anesthetized dog. Twelve dogs were divided into two groups. : saline pretreatment group (control, N=6) and clonidine pretreatment group (clonidine group, N=6). The dogs were anesthetized with N2O-O2-enflurane and vecuronium. Thoracotomy was done in 4th or 5th intercostal space for open cardiac massage. After confirming stability of vital signs, we administered clonidine (10 mcg/kg) or saline, and then administered bupivacaine with the rate of 2 mg/kg/min. When the electeocardiogram showed asystole, 20 mcg/kg of epinephrine was administered via central venous line and open cardiac massage with the rate of 120 beat/min. was performed. We observed electrocardiogram (lead II), arterial blood pressure, heart rate, dose of infused bupivacaine to be required for QRS widening and arrest, required time and administered dose of epinephrine for resuscitation. RESULTS: Clonidine group showed significant decrease of heart rate after pretreatment (p<0.05). There was no significant difference in required dose for QRS widening between two groups. The dose administered for inducing arrest was less in clonidine group than control group (p<0.05). The time required for resuscitation was shorter in clonidine group than control group (p<0.05). The total dose of epinephrine required for resuscitation was less in clonidine group than control group (p<0.05). The blood concentration of catecholamine did not showed significant difference during the whole course of experiment. CONCLUSIONS: Above results demonstrated that clonidine, a central nervous system-mediated sympatholytic agent, facilitated cardiac arrest when bupivacaine was infused intravenously and cardiac rescucitation.
Analgesia ; Animals ; Arterial Pressure ; Bupivacaine ; Clonidine* ; Dogs* ; Electrocardiography ; Epinephrine ; Heart Arrest ; Heart Massage ; Heart Rate ; Injections, Intravenous ; Resuscitation* ; Seizures ; Thoracotomy ; Vecuronium Bromide ; Vital Signs

Mucoceles usually occur as solitary, asymptomatic, translucent, and dome-shaped cysts containing clear viscous fluid on lower lip or oral mucosa. The authors reviewed the clinical and histopathological findings in 33 patients with mucocele and attempted to clarify the difference between the histopathologic types (retention and extravasation). The results were summarized as follows. 1. Age distribution was from 2 to 53 years and mean age was 21.4 years. Male to female ratio was 1.2:1(18 males.15 females). 2. Histopathologic type was classified. 4 cases(12.1%, mean age.17.3 years) were retention type, 19 cases(57.6%, mean age.'21.5 years) mixed type, and 10 cases(30.3 %, mean age.20.9 years) extravasation type. Among 19 mixed types, 13 cases were retention dominant and 6 cases extravasation dominant. 3. Durations from the onset to the diagnosis could be clarified in 16 cases. Those were below 1 year in 14 cases(87.5% ) and below 3 years in 16 cases all. Mean duration was 9.4 months. 4. The sites of involvement were lower lip(72.7%), tongue(24.3%), and oral mucosa(3.0%), in decreasing order of frequency. 5. The visited departments were otolaryngology(72.7%), dentistry(12.1%), plastic surgery(9,1%) and dermatology(6.1%), in decreasing order of frequency. 6. In the histopathologic observation, surface epithelium was observed in 25 cases (75.8%), cyst in 23 cases(69.7%), granlation tissue in 29 cases(87.9%), mucin in 28 cases(84.8%), surrounding salivary glands in 20 cases(60.6%) and foamy macrophages in 32 cases(97.0% ), 7. Special stains(PAS, D-PAS, and alcian blue at pH2.5 and 0.4) for the mucin were performed in 10 cases. The results were compatible with sialomucin.
Age Distribution ; Alcian Blue ; Diagnosis ; Epithelium ; Female ; Humans ; Lip ; Macrophages ; Male ; Mouth Mucosa ; Mucins ; Mucocele* ; Salivary Glands ; Sialomucins

INTRODUCTION: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. MATERIALS AND METHODS: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. RESULTS: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was 43.74+/-11.96% and 30.79+/-2.93%, respectively. CONCLUSION: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.
Alveolar Process ; Bone Regeneration ; Hand ; Mandible ; Osteogenesis ; Regeneration ; Swine, Miniature ; Tooth ; Transplants

The purpose of the study is to evaluate the differential effects caused by the interviewers and the days of the week using the 24-hour dietary recall method on the dietary evaluation of nutrient intakes. Thirteen subjects were interviewed by three trained interviewers on a Monday, Wednesday, and Friday. The consumption of nutrients by the subjects during each day was assessed. The average intake of nutrients was found to be sufficient except in calcium, iron, and vitamin A. there was a significant difference between the food intake on the weekdays and that o the weekend. However, the were no significant differences between the interviewers assessments on the intake of nutrients consumed by the subjects. The standardization of the portion size, interview skill and experience may be a few of the reasons explaining the elimination of the potential error created by variations among the interviewers. This study suggests that repeated 24-hour recalls during weekdays and weekends may be a better method for estimating the nutrients consumed by the subjects.
Calcium ; Eating ; Interviews as Topic ; Iron ; Portion Size ; Vitamin A

Intralabyrinthine schwannomas are rare benign tumors, which arise from neural portions within the labyrinth. These are subclassified into seven groups according to the affected inner ear structures. Intracochlear schwannomas (ICS) are tumors confined to the cochlea, and these can cause progressive unilateral sensorineural hearing loss, tinnitus, vertigo and aural fullness. Here, we report a 49-year-old female patient with left sudden sensorineural hearing loss. There was no improvement of hearing despite steroid and hyperbaric oxygen therapy. Space occupying lesion in the basal turn of the left cochlea was identified in MRI with enhancement. She underwent tumor removal through an extended round window approach, and cochlear implantation was performed successfully. This is the first case report of cochlear implantation after tumor removal in a patient with ICS in Korea, and we discuss management options with a review of the literature.

PURPOSE: The purpose of this study was to compare anxiety, depression and quality of life according to the severity of urinary incontinence in married women. METHOD: The participants were 168 married women aged 30-65 years who experienced urinary incontinence. The data were collected from May to July, 2006 using a structured questionnaire. Frequencies, percent, means and standard deviation, t-test, ANOVA, chi-square-test and Scheffe test with SPSS win 14.0 program were used to analyze the data. RESULTS: The distribution of urinary incontinence severity was mild 87.5%, or moderate 12.5%. Significant differences in the severity of urinary incontinence were found for the general characteristics of age, education level, having a job and having a spouse and for the obstetric characteristics of type of delivery, and menopause. Differences in the score for anxiety (t=-2.41, p=0.001) and quality of life (t=5.50, p<0.001) according to the severity of urinary incontinence were statistically significant. CONCLUSION: Women with moderate to severe urinary incontinence should be screened for psychosocial factors. Severity of urinary incontinence in married women negatively affects their quality of life. Further research is needed to determine factors predicting the quality of life for incontinent women.
Anxiety* ; Depression* ; Education ; Female ; Humans ; Menopause ; Psychology ; Quality of Life* ; Surveys and Questionnaires ; Spouses ; Urinary Incontinence*

PURPOSE: This study aimed to investigate the safe medication utilization and the education demands during pregnancy and it further reported the development of educational materials for pregnant women. METHODS: A survey was conducted in two tertiary care university hospitals and one community hospital specialized in obstetrics and gynecology from July 2 to 29 2014. The survey questionnaires included the usage of medications and the unmet needs on medication use during pregnancy. Ad ditionally, pregnant women's requests regarding to medication use were collected through group interviewing of community pharmacists. Based on these results, educational materials were de veloped and implemented. After implementing the education sessions, the satisfaction was evaluated. RESULTS: A total of 152 pregnant women answered completely the questionnaire. Among them, 130 participants (42.8%) were given the medication information from their physicians. Exposure to a teratogenic drug during pregnancy was a major concern for most pregnant women (79.6%). The majority (90.1%) of subjects reported a necessity of medication-related education during their pregnancy. The interview with 48 pharmacists indicated that the most commonly used OTC drugs in pregnancy were vitamins (25.2%), iron supplements (23.7%), and the most frequently used prescription drugs were antiinflammatory-analgesics (25.3%), followed by antibiotics (20.9 %). Based on the results, booklets of drug therapy during pregnancy, leaflet of pregnancy category index were made. Also, on-line flash and presentation materials for instructors were prepared. Through the trial education with the developed materials, it was confirmed that the contents of education materials were well understood and satisfied by the pregnant women. CONCLUSIONS: This study showed the need of the medication-related education for the pregnant women. The developed education materials would be helpful sources to provide accurate and reliable medication-related information to health professionals and pregnant women.
Anti-Bacterial Agents ; Drug Therapy ; Education ; Female ; Gynecology ; Health Occupations ; Hospitals, Community ; Hospitals, University ; Humans ; Interviews as Topic ; Iron ; Nonprescription Drugs ; Obstetrics ; Pamphlets ; Pharmacists ; Pregnancy* ; Pregnant Women ; Prescription Drugs ; Tertiary Healthcare ; Vitamins

BACKGROUND AND OBJECTIVES: Caloric nystagmus has been known since a century ago, and the thermal convection theory proposed by Barany has been widely accepted. Gravity plays an important role in thermal convection. In 1984, caloric nystagmus was reported in weightless space environments and although the response was weak, the nystagmus was found to occur in the same direction as the earth. This implies that factors other than thermal convection might participate in the caloric nystagmus. MATERIALS AND METHODS: Using 50 normal ears as subjects, this study compared the responses of conventional caloric test and reversed caloric test, which places the plane of the lateral semicircular canal upside down. RESULTS: The direction of the nystagmus was reversed, and the maximal slow phase velocity was decreased compared to that of the normal caloric test. CONCLUSION: The reversed direction of the nystagmus observed in this study basically supports the theory by Barany, however, the differences that are noted implicate that other factors with a certain direction maybe involved.
Caloric Tests* ; Convection ; Ear ; Gravitation ; Nystagmus, Physiologic ; Semicircular Canals

OBJECTIVE: To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. METHODS: The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. RESULTS: The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. CONCLUSION: In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.
Activities of Daily Living ; Appointments and Schedules ; Humans ; Stroke ; Upper Extremity