BACKGROUND: In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of FEV1 in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of FEV1 especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and FEV1 in healthy children. METHOD: PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children (age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of FEV1 by PEF were derived. RESULTS: 1. The regression equation for PEF(L/min) was:12.6×age(year)+3.4×height(cm)-263(R2=0.85) in boys, and 6×age(year)+3.9×height(cm)-293(R2=0.82) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for FEV1(ml) by PEF(L/min) was:7×PEF-550(R2=0.82) in boys, and 5.8×PEF-146(R2=0.81) in girls, respectively. CONCLUSION: This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for FEV1, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.
Airway Obstruction ; Asthma ; Child* ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Reference Values

BACKGROUND: We investigated whether culture using an automated blood culture system enhances the recovery of bacteria and fungi from body fluids other than blood when compared to conventional solid media culture methods. METHODS: A total of 734 specimens [ascites (n=457), bile (n=5), CAPD (n=28), CSF (n=32), joint fluids (n=165), pericardial fluid (n=17), and pleural fluid (n=30)] were included in the study. Half of the volume of each specimen was inoculated directly into automated blood culture bottles (bioMeriux, Marcy-I'Etoile, France). The remaining volume was inoculated onto conventional solid media (sheep blood agar, chocolate agar, and phenylethyl alcohol agar) after centrifuging at 3,000 rpm for 10 min. RESULTS: Clinically significant microorganisms were isolated from 62 specimens (8.5%) by automated blood culture and 61 specimens (8.3%) by the conventional solid media culture (kappa index: 0.81, 95% confidence interval: 0.75~0.89). Contamination was observed in 11 (1.8%) of the automated blood culture specimens and 3 (0.4%) of the solid media culture specimens. The mean turnaround times of the automated blood cultures and the conventional solid media cultures were 3.7 and 2.8 days, respectively (P<0.0001). CONCLUSION: Compared with conventional culture methods, no improvement in the recovery of clinically significant microorganisms was noted with the use of the automated blood culture system for the culture of body fluids other than blood.
Agar ; Bacteria ; Bile ; Body Fluids ; Cacao ; Fungi ; Joints ; Peritoneal Dialysis, Continuous Ambulatory ; Phenylethyl Alcohol

The use of the computer in medicine has been increasing rapidly. Despite this growing use of them, however, they have yet to assume a major role in assisting the physician. The purpose of this article, using dBASE ll, is to assist an anesthesiologist by rapid search of his(her) own references in preparing educational material or do research and so on. This software was written to be an efficient alternative to the conventional manual searching and to provide the following features: 1) personnel unfamiliar with computer technology could achieve satisfactory results. 2) rapid data entry of raw data with conventional keystrokes. 3) extensive data editing and manupulation capabilities. 4) entering each data typed by user was indexed alphabetically in sequence of authors' name. 5) easy search of data through the authors name, title, keyword and identifying of them in CRT displays or printer. Using a microcomputer for data processing had several advantages over a conventional manual method.: 1) less time required to retrieve information. 2) visual presentation of data was facilitated. 3) data were more readily obtainable. But the major disadvantage of a computerized system were the initial time consumed during the input of the data.
Microcomputers*

We tested the hypothesis that the extent of necrosis at the initial MRI predicts the subsequent risk of collapse of the femoral head in a randomized clinical trial conducted to compare the core decompression to the conservative treatment. After the initial clinical evaluation including plain roentgenography and MRI, 37 hips of early-stage osteonecrosis (ON) in 33 patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation including plain roentgenography and MRI at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal aod sagittal MR images. The angle of necrotic portion in mid-coronal image (A) and that in mid-sagittal image (B) were used to quantify the extent of necrotic portion by the formula; (A/180) x (B/180) x 100%. A strong association was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion, which might be useful as a predictive index for the fate of early-stage ON.
Classification* ; Decompression ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Radiography ; Risk Factors ; Weight-Bearing

OBJECTIVE: To Compare the conventional Pap smear with the Liquid Pap smear in screening of cervical cancer and to evaluate the correspondence of their biopsy results. METHODS: From August 1, 2003 to July 31, 2005, the conventional Pap smears and the Liquid Pap smears were performed in 12,757 and 6,870 women, respectively. The results of 252 conventional Pap smear and 227 Liquid Pap smear were confirmed by colposcopic biopsy and evaluated for sensitivity, specificity, positive predictability, negative predictability and false negativity. RESULTS: In Liquid Pap smear, there were higher proportions of ASCUS, LSIL, HSIL and CIS. And the ratio of ASCUS/LSIL were 3.32 and 3.04 in conventional Pap smear and Liquid Pap smear respectively. The conventional Pap smear showed sensitivity 71.8%, specificity 93.9%, positive predictability 82.3%, negative predictability 89.4%, and false negativity 28.2%, while the Liquid Pap smear showed higher sensitivity (72.6%), specificity (96.1%), and positive predictability (89.8%), and lower negative predictability (88.0%), and false negativity (27.4%). The positive predictability was significantly higher (95% C.I.: 1.3-13.7). CONCLUSION: The positive predictability was significantly improved in the Liquid Pap smear. Therefore, the Liquid Pap smear is a more useful method in screening of cervical cancer.
Biopsy ; Female ; Humans ; Mass Screening ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

BACKGROUND/AIMS: Lung cancer is the leading cause of cancer death worldwide. There are significant gender differences in lung cancer: most females with lung cancer are non-smokers and they are diagnosed with adenocarcinoma. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are more effective in female lung cancer patients, but the results with gefitinib and erlotinib differ. This study compared the therapeutic response and toxicity of gefitinib and erlotinib in female lung cancer patients. Method: We retrospectively reviewed the clinical information on patients treated with gefitinib or erlotinib for more than one month at Kosin University Gospel Hospital from February 2004 to November 2007. RESULTS: Forty-two patients (26 gefitinib vs. 16 erlotinib) were enrolled during this period. Their median age was 58 years. Thirty-six patients (85%) were non-smokers and 35 patients (83%) had adenocarcinoma. There were 24% at stage IIIb and 76% at stage IV. The median survival time was 793 days. In the gefitinib group, 69% of the patients received 3rd-line chemotherapy, while 12 of 16 (87.5%) in the erlotinib group received 2nd-line chemotherapy. There were no significant differences in the overall response rate (gefitinib 39% vs. erlotinib 31%, p=0.524), median survival time (gefitinib 605 days vs. erlotinib 510 days, p=0.455), and time to progression (gefitinib 186 days vs. erlotinib 262 days, p=0.660). Rashes were more common in the erlotinib group (73.3% vs. 27%, p<0.001). CONCLUSIONS: There were no significant differences in the response rate, overall survival, and time to progression between the two groups. Rashes were more common in the erlotinib group.
Adenocarcinoma ; Exanthema ; Female ; Humans ; Lung ; Lung Neoplasms ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Erlotinib Hydrochloride

OBJECTIVES: The purpose of this study is to evaluate the problem behaviors of adolescents and to discriminate between parenting behaviors of problem behavior groups and those of non-problem behavior group. METHODS: The subjects of this study were 792 high school students in Seoul. We administered 'Parenting Behavior Inventory' and Korean version of Youth Self-Report(K-YSR) to the subjects in order to evaluate the parenting behaviors perceived by adolescents and the problem behaviors of adolescents. We analyzed the relationship between parenting behaviors and problem behaviors. We classified the subjects into problem behavior groups(internalizing group, externalizing group, internalizing-externalizing group) and a non-problem behavior(normal) group. We studied the differences of parenting behaviors among the groups. RESULTS: The results are as follows. 1) There were significant negative correlations between the positive parenting behaviors such as affection, reasoning, and monitoring and the problem behaviors of adolescents. By contrast, there were significant positive correlations between the negative parenting behaviors such as physical abuse, intrusiveness, over-expectation, neglect, and inconsistency and the problem behaviors of adolescents. 2) Adolescents of the internalizing group perceived significantly more parental abuse, intrusiveness, over-expectation, neglect, and inconsistency than those of normal group. Meanwhile, they perceived significantly less affection than normal adolescents. Adolescents of the externalizing group also perceived significantly more parental abuse, intrusiveness, over-expectation, neglect, and inconsistency than those of normal group. Also, they perceived significantly less monitoring than normal adolescents. 3) Adolescents of the internalizing-externalizing group perceived significantly more intrusiveness from both parents than those of either the internalizing or the externalizing groups. Adolescents of the internalizing-externalizing group perceived significantly less affection and more neglect from their mothers than those of the internalizing or the externalizing groups. In addition, adolescents of the internalizing-externalizing group perceived significantly more physical abuse from their fathers than those of the internalizing or the externalizing groups. CONCLUSION: Parenting behaviors such as abuse, intrusiveness, over-expectation, neglect, and inconsistency are associated with both internalizing and externalizing problems. In contrast, our results suggest that parenting behaviors such as affection, monitoring, and reasoning might decrease the various problem behaviors of adolescents.
Adolescent* ; Fathers ; Humans ; Mothers ; Parenting* ; Parents* ; Seoul

Nocardia species are opportunistic pathogens that are known to affect mostly the immunocompromised patients. Recently, we experienced a young systemic lupus erythromatosus female patient having infected with Nocardia species, which we were able to isolate from her lung abscess. The patient is twenty-nine years old female who was diagnosed as having systemic lupus erythromatosus two years ago and is currently engaged with ongoing treatment. During her admission, new symptoms of fever and dyspnea along with a lesion in the apical lobe of her left lung found by simple chest X-rays were observed. Under lung biopsy examination, there were seen neutrophilic exudates that were gram-positive, AFB-negative, and modified AFB-positive. By culturing the biopsy material, we found gram-positive, AFB-negative, and modified AFB-positive branching hyphaes that were morphologically matched for Nocardia species. We have analyzed the Nocardia DNA by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and found the organism to be Nocardia asteroides type I. Treatment of patient was done using sulfamethoxazole/trimethoprim and ceftriazone, and her clinical conditions as well as her radiological findings improved.
Biopsy ; DNA ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Humans ; Hyphae ; Immunocompromised Host ; Lung ; Lung Abscess ; Neutrophils ; Nocardia ; Nocardia asteroides* ; Pneumonia* ; Polymerase Chain Reaction ; Thorax

The purpose of this study was to explore the parents and child relationship in traditional Korean society through the Korean classic novels. The Data were analyzed through latent content analysis in focusing on the parents and child relationship. Forty-six Korean classic novels written in Chosun Dynasty (from 1392 to 1910 AD) were chosen to analyze and they were represented the characteristic Confucian ideas. The sentences containing the expression of child-care and parent-child relationship were selected during intensive reading line by line and analyzed. Sixty-nine meaningful concepts were drawn out from 258 significant sentences by the similar meaning and common theme and classified as 3 categories and 11 sub-categories. The important parent-child relationship expressed in Korean traditional society were as follows: From the category of the Meaning of Child, 4 sub-categories were drawn; gift of heaven, successor of the family line, driving power of life, and rewards from the offspring. From the category of attitude to the child, 3 sub- categories were drawn; a notion of preferring a son to a daughter, close maternal-child relation, and expectation to the future of child. From the category of nurturing behavior, 4 subjects were drawn; Tae-Gyo(fetal education), affective behavior, socialization, and health management behavior. Above result helps to improve the basic understanding the relationship of parent and child in modern society. And by the understanding of child in the family, unhealthy relationship of parent and child can be prevented and furthermore family centered child health promotion can be achieved.
Child ; Humans ; Nuclear Family ; Parent-Child Relations* ; Parents ; Reward ; Socialization ; Child Health

Pemphigus vulgaris is autoimmune disease characterized by acantholysis and blister formation in the skin and mucosa. The introduction of corticosteroids has greatly reduced mortality, and a number of immunosuppressive agents, such as azathioprine and cyclophosphamide are recommended as adjuncts to oral steroids. A 38-year-old female patient of pemphigus vulgaris has been managed with daily oral cyclophosphamide as adjunct to prednisolone for about 11 months, and then transfered to our department due to amenorrhea for 4 months. Hormonal profile of FSH, LH and estradiol revealed in postmenopausal range and follow-up results of hormonal profile were not changed, and amenorrhea continues for total 13 months until now. So we report a case of premature ovarian failure complicated by long-term oral administration of cyclophosphamide.
Acantholysis ; Administration, Oral ; Adrenal Cortex Hormones ; Adult ; Amenorrhea ; Autoimmune Diseases ; Azathioprine ; Blister ; Cyclophosphamide* ; Estradiol ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Mortality ; Mucous Membrane ; Pemphigus* ; Prednisolone ; Primary Ovarian Insufficiency* ; Skin ; Steroids