This study was conducted to investigate the choline intake of Korean adults for the purpose of preparing a basal data required for the establishment of choline adequate intake (AI). The subjects of 56 Korean young adults were recruited from college students of 20 to 30 years old in Daejeon city. The aliquots of foods that the subjects ate for one day were collected with use of duplicate food collection method and choline content of one day meal directly was analyzed with the use of enzymatic method. Choline intakes of male subjects were in the range of 353.5 ~ 1222.5 mg and those of female subjects were in the range of 213.1 ~ 722.3 mg. Mean intakes of choline were 658.2 +/- 243.9 mg/day in male subjects and 423.3 +/- 133.6 mg/day in female, therefore choline intake of men was about 200mg higher than that of women. Median value in total subjects was 496 mg, male's median was 608.8 mg, female's median was 419.9 mg. When the subjects were devided into 4 groups by choline intake, as less than 75%, 75 ~ 100%, 100 ~ 125% and over 125% based on choline AI of USA (males: 550 mg, females: 425 mg), there was no significant difference between men (64.3%) and wemen (67.9%) in the distribution of the subjects whose choline intake is under the range of 75 ~ 125% AI of USA. However, 10.7% of men and 21.4% of female had choline intake less than 75% AI of USA while the cases of choline intake higher than 125% AI were 25% in male and 10.7% in female. Thus, it is assumed that female case in choline-deficient state would be two times more than male. When adjusted by body weight, choline intake was 9.5 +/- 3.4 mg/kg in men, 8.1 +/- 3.1 mg/kg in women and 8.8 +/- 3.3 mg/kg in total subjects. And choline intake per 1,000 kcal of men, women and total subjects were 277.1 +/- 78.4 mg, 275.9 +/- 62.1 mg and 276.5 +/- 70.1 mg respectively. From these results, it is suggested that these levels of 276.5 +/- 70.1 mg/ 1,000 kcal or 8.8 +/- 3.3 mg/kg B.W. can be used as a reference value for the establishment of AI of choline for Korean, because overall choline intake of these subjects was not in lower state compared to other nutrients intakes obtained from calculation of the food the subjects had taken.
Adult ; Body Weight ; Choline* ; Female ; Humans ; Male ; Meals ; Reference Values ; Young Adult

OBJECTIVE: To investigate neurodevelopmental long-term outcome in children born after in-vitro fertilization (IVF). METHOD: We performed retrospective study in which we investigated development of neurodevelopmental disability in 254 childern (113 twins, 28 singletons) born after in vitro fertilization between Janurary 1995 and December 1999. We obtained neurodevelopmental status on a certain date and disability of children from medical records or phone interviews of parents. We assessed developmental status, congenital malformation, cerebral palsy and seizure, speech disorder, other neurologic problems, prematurity, low birth weight, maternal age, intraventricular hemorrhage (IVH), retinopathy and congenital anomaly. RESULTS: Six children (2.3%) were diagnosed as cerebral palsy, three children (1.2%) as developmental delay and 11 had IVH, 6 had retinopathy, 10 had congenital anomaly (esp. abdominal wall defect). The mean maternal age was 30+/-2.8 years old and gestational age was 35+/-3.0 weeks. One hundred one children (39.7%) were born prematurely, 66.5% low birth weight. CONCLUSION: High prevalence of neurodevelopmental disabilities like cerebral palsy compared to population controls (cerebral palsy: 1.9/1000 live birth) was revealed. Therefore, we should know mild high risk of developmental disability and do developmental examination carefully in children born after IVF and long-term follow up.
Abdominal Wall ; Cerebral Palsy ; Child* ; Developmental Disabilities ; Fertilization ; Fertilization in Vitro* ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Maternal Age ; Medical Records ; Paralysis ; Parents ; Population Control ; Prevalence ; Retrospective Studies ; Seizures ; Twins

Lingual tonsillar hypertrophy (LTH) is a rare and dangerous condition in the management of the upper airway. It is not detectable from the history or on routine preoperative physical examination. Enlarged lingual tonsils can cause posterior displacement. A 56 year old man was scheduled for emergency laryngeal microscopic surgery for the removal of a throat foreign body. After the induction of general anesthesia, intubation with a rigid laryngoscope was impossible due to LTH. After recovery of self respiration, the endotracheal tube intubation was possible by the combined use of a laryngoscope, Magil forceps and fiberoptic bronchoscope.
Anesthesia, General ; Bronchoscopes ; Emergencies ; Foreign Bodies ; Humans ; Hypertrophy* ; Intubation* ; Laryngoscopes ; Middle Aged ; Palatine Tonsil ; Pharynx ; Physical Examination ; Respiration ; Surgical Instruments

Purpose: This descriptive study investigated the effects of nurses’ knowledge of withdrawalof life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants’ scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65± 0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion This study showed that perceptions of hospice were an important fac-tor influencing nurses’ attitudes toward withdrawal of life-sustaining treatment. Therefore,it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

Recently, the incidence of pertussis has been increasing; however, reports on mixed infection of pertussis with other respiratory pathogens are rare in highly immunized populations. We report the case of a 10-year-old girl who presented with cough, post-tussive emesis, and fever. She was subsequently diagnosed with bronchopneumonia. Although she had received five doses of diphtheria-tetanus-acellular pertussis vaccine, polymerase chain reaction of her nasopharyngeal aspirate confirmed Bordetella pertussis infection. In addition, serologic testing for Mycoplasma pneumoniae was also positive. The patient was treated with roxithromycin without any complications. This is the first report of mixed B. pertussis and M. pneumoniae infection in Korea. To avoid under-diagnosis, pertussis should be considered in patients with chronic cough even when other respiratory pathogens have been documented.
Bordetella pertussis ; Bronchopneumonia ; Child* ; Coinfection ; Cough ; Female* ; Fever ; Humans ; Incidence ; Korea ; Mycoplasma Infections* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pertussis Vaccine ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Roxithromycin ; Serologic Tests ; Vomiting ; Whooping Cough*

Objective: This study aims to identify the usefulness of voice function in early screening for dysphagia. We sought to evaluate if screening tests through the functions of production and quality of voice were correlated with aspiration in dysphagic patients. Methods: This study involved 55 participants who were referred to videofluoroscopic swallowing study (VFSS) for suspected dysphagia. Blinded examiners rated the voice production function (MVI, MPT) using a portable instrument and evaluated the quality of voice (jitter, shimmer, NHR) using Visi-pitch. Swallowing functions were also evaluated by utilizing the penetration-aspiration scale (PAS), American Speech-Language-Hearing Association (ASHA), National Outcome Measurement System (NOMS) swallowing scale and VDS. The patients were divided into two groups, the penetration group, and the aspiration group according to the PAS score. The difference in variables was analyzed using the Mann-Whitney U test between the two groups. The relationship between voice parameters and swallow-related parameters was determined using the Spearman correlation coefficient. In addition, the cut-off, sensitivity, and specificity of meaningful variables in silent aspiration were analyzed using the ROC curve analysis. Results: The functions of production and quality of voice were found to be significantly different between the penetration and aspiration groups (P＜.000). The PAS score was correlated with all parameters of the functions of production and quality of voice (P＜.001). VDS was correlated with MVI, ASHA was correlated with MVI, and Shimmer (P＜.001). The meaningful variables for silent aspiration were jitter and shimmer. Conclusion Through a clinical screening test, it may be possible to predict the difference between penetration and aspiration through the functions of production and quality of voice.

The purpose of this study is to investigate the concentration of plasma choline of Korean and to clarify the relationship between plasma choline concentration and choline intake. Plasma choline concentration of 30 young adults (15 males, 15 females) aged 20 - 30 years living in Deajeon metropolitan city are analyzed and their dietary choline intake. Choline content of one day meal was directly analyzed with the use of enzymatic method. Plasma choline concentration from more than 12 hr fasting blood was analyzed by using HPLC-MS. Choline intakes of male subjects were in the range of 253.51 - 1724.14 mg and those of female subjects were in the range of 240.85 - 938.06 mg. Mean intakes of choline were 634.53+/-353.68 mg in male subjects and 473.99+/-183.76 mg in female subjects. Plasma choline concentration of total subjects was in the range of 5.08 - 14.01 micro mol/L. Mean plasma choline concentration was 9.19+/-2.05 micro mol/L in male subjects and 8.11+/-1.70 micro mol/L in female subjects. Plasma choline concentration did not show significant correlation with choline intake in male and total subjects, but showed positive correlation with choline intake in female subjects (p<0.05). This result shows that more studies on large scaled samples are needed.
Choline* ; Daejeon ; Fasting ; Female ; Humans ; Male ; Meals ; Plasma* ; Young Adult*

Iatrogenic fracture is not popular and might be recognized as a malpractice. Surgical error related to iatrogenic fracture which has occurred after an operation can be detected only by a surgeon. Stress riser fracture is another form of iatrogenic fracture also known as a Young's modulus fracture. As the majority of surgical related stress riser fractures can be preventive, the accurate prevalence is not known. The majority of fractures occurred in the weight bearing bones such as femur and tibia. The subtrochanter area is the most stress concentrated area in the human body, thus it is a common area for occurrence of stress riser iatrogenic fractures. We experienced 2 cases of stress riser iatrogenic fractures, which are related to technical errors, thus we report cases with literature review.
Elastic Modulus ; Femur ; Hip Fractures* ; Human Body ; Iatrogenic Disease ; Malpractice ; Medical Errors* ; Prevalence ; Tibia ; Weight-Bearing

OBJECTIVE: The aim of this study was to estimate the feasibility, safety and surgical outcomes of single port access laparoscopic myomectomy (SPA-M). METHODS: We reviewed the medical records of 29 patients with uterine leiomyoma who underwent SPA-M in Gumi CHA hospital between March 2010 and August 2010. We performed SPA-M with conventional rigid straight laparoscopic instruments in all cases. RESULTS: In this study, the mean of leiomyoma weight, operating time, and estimated blood loss were 55.43 gm(+/-54.79, range 5~220 gm), 69.68 min (+/-32.99, range 20~120 min.), 100 mL (+/-104.26 range minimal~300 mL), respectively. Transfusion was done in the one case. CONCLUSION: SPA-M using conventional rigid straight laparoscopic instruments was feasible and could be an alternative to conventional multi-port access laparoscopic myomectomy (MPA-M).
Humans ; Leiomyoma ; Medical Records

PURPOSE: To report 2 young female patients with bilateral posterior scleritis and serous retinal detachment. CASE SUMMARY: An 11-year-old girl (Case 1) and a 16-year-old girl (Case 2) visited our clinic with bilateral ocular pain, redness, and blurred vision. Slit lamp examinations revealed severe bilateral scleral injection and mild anterior chamber reactions. Fundus examinations showed bilateral serous retinal detachments in the macular area. In both patients, diffuse multifocal leaking and pooling were found at the macula in the early and late phase fluorescein angiography, respectively. On the B-mode ultrasounds and orbital images (MRI or CT), scleral thickening with retention of subtenons fluid were found. There were no systemic diseases associated with the conditions. We diagnosed the patients with bilateral posterior scleritis and administered systemic steroids. After systemic steroid treatment, all of the symptoms were alleviated. Three months after the regression, bilateral posterior scleritis recurred in patient 2. Oral cyclosporine 100 mg was additionally prescribed in addition to the previous medications that she had taken during her first treatment. CONCLUSIONS: Two young patients diagnosed with posterior scleritis and serous retinal detachment was treated with systemic steroids. With proper examination and treatment, posterior scleritis can be treated with no complications.
Adolescent ; Anterior Chamber ; Child ; Cyclosporine ; Female ; Fluorescein Angiography ; Humans ; Orbit ; Retention (Psychology) ; Retinal Detachment ; Retinaldehyde ; Scleritis ; Steroids ; Vision, Ocular