Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

No abstract available.
Humans ; Microcomputers* ; Stomach Neoplasms*

The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. According to several studies, menarcheal age in Korean girls has dropped from about 15 years of age in 1960s to 13.5 years of age in 1980s. This findings show a pronounced secular trend to earlier maturation. The purpose of this study is to determine (1) the average age at menarche in Korea in present time, (2) the secular trend of menarcheal age, and (3) the geographic regional influence on menarche. The data sampling was obtained from the physical examination cards of women students in Yonsei University who entered from 1983 to 1991. The data which was obtained from the number of 7761 was analysed by dBase III plus and SAS program. The results are as follows: 1) The mean menarcheal age of the subjects was 13.7+/-1.2 years. 2) Age at menarche has been getting earlier by some 7.4 months during the period of recent II years. 3) Comparing to the decreasing secular trend of menarcheal age, the height and weight showed increasing trend. 4) There were significant differences in menarcheal age, height, weight among geographic regions. We conclude that the results indicate an accelerating secular trend in age of menarche in Korea.
Adolescent ; Female ; Humans ; Korea* ; Menarche ; Physical Examination ; Puberty ; Sexual Maturation

BACKGROUND: In women, the prevalence of depression is known to be more than twice as high as in men. Because many depressive women complain of their somatic symptoms instead of neurovegetative ones, many cases of depression have been misdiagnosed. Women also tend to use medicine more frequently than men do to manage depression. So we investigated the relationship between somatic symptoms and drug use in housewives for better management. METHODS: From 1st. March to 31st. March in 1996, the prepared questionnaires were presented to housewives living in the area of Kyung-ju city, who responded the questionnaires under direct interview. The questionnaire was composed of two parts. One part included demographic data, somatic complaints, drug use, places of drug purchase, current diseases that had been diagnosed by doctors. The other included Korean standard Beck Depression Inventory-questionnaire. The subjects were divided into two groups by BDI score(21 point), which was the cut-off point for depression in Korea. The relationships of somatic symptoms and drug use between the two groups were analyzed. RESULTS: There were 110 housewives who had depressive trends among 569 respondents. In general characteristics, there was significant difference between the two groups except the item of religion. In the items of somatic symptoms, there were more somatic symptoms in the group of high BDI score(>_21) except fatigue(P<0.01). More drug users were found in the group of high BDI score(>_21) (P<0.05). In the group of high BDI score(>_21), there was definite correlation between the items of somatic symptoms and drug use. There was no difference between the two groups in the item of drug purchase site. The most common site of drug purchase was the drug store in both groups. CONCLUSIONS: Depressive housewives complained of more somatic symptoms and more often used drugs as well.
Surveys and Questionnaires ; Depression ; Drug Users ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence

PURPOSES: This study examined the relationship between risk behaviors and sexual knowledge, sexual attitudes, and sexual experiences of male high school students. METHOD: A cross-sectional, descriptive study was conducted. Data were collected from 2 male high schools in metropolitan Gwangju. Five hundred forty-eight boys were enrolled in this study. Descriptive statistics, factor analysis, t-test or ANOVA, and Pearson's correlation were used for data analysis. RESULTS: The mean sexual knowledge and sexual experience scores were relatively low, 0.60 out of 1 point, and 0.75 out of 4 points, respectively. Three attitude types of the students were identified: permissible, conservative and pleasure seeking attitude. The score of the permissible type was affected by the subjects' exposure to pornographic material. The score of the conservative type was affected by alcohol consumption and acquaintances with a heterosexual friend. The score of the pleasure seeking type was affected by their exposure to pornographic material, alcohol consumption, smoking, going to a video-room, and acquaintances with a heterosexual friend. There was a negative correlation between the permissible type and sexual knowledge, and a positive correlation between the conservative and pleasure seeking types and sexual experience. CONCLUSION: Male high school students who have been exposed to risk behaviors have a higher likelihood of indulging in sexual activity, and the pleasure seeking type appears to be related to sexual experience. An educational program may be needed to prevent risky behaviors and sexual experiences in male high school students considering their sexual attitude type.
Alcohol Drinking ; Friends ; Gwangju ; Heterosexuality ; Humans ; Male* ; Pleasure ; Risk-Taking* ; Sexual Behavior ; Smoke ; Smoking ; Statistics as Topic

Hemorrhagic complications associated with aspirin use occur primarily at skin or gastrointestinal sites but can occasionally occur in the central nervous system. In particular, spontaneous spinal epidural hemorrhage (SSEH) associated with aspirin is very rare. We report a case of low-dose (100 mg daily) aspirin-related SSEH that was successfully treated with medical management. Our case indicates that low-dose aspirin could induce SSEH and that conservative treatment with close observation and repeated imaging studies should be considered in cases with neurological improvement or mild deficits.
Aspirin ; Central Nervous System ; Hematoma ; Hematoma, Epidural, Spinal ; Skin

Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

Small-bowel tumors, both benign and malignant, are rare lesions that clinicians often do not encounter, accounting for less than 2% of gastrointestinal malignancies. Usually, benign small-bowel tumors, including polyps, are asymptomatic. The diagnosis of small-bowel tumors is difficult because of an often-delayed presentation and nonspecific signs and symptoms. We report an incidentally detected case of a long, pedunculated, large polyp of the terminal ileum, which protruded through the ileocecal valve into the cecum that was removed by colonoscopy in a 41-year-old male with intermittent right-sided lower-abdominal pain. The polyp was resected through snare polypectomy without complications. The histopathology of the resected polyp was confirmed as an ileal hyperplastic polyp. Two years later, there was no recurrence observed via postpolypectomy surveillance colonoscopy.

Anal gland/duct cyst (AGC) is rare and observed in only 0.05% of patients undergoing anal surgery. AGC is thought to be a retention cyst in the anal gland and arises when an obstruction of the anal duct causes fluid collection in the anal gland. We report a case of AGC in a 66-year-old woman without anal symptoms. Found by colonoscopy, the AGC was excised transanally. The histopathology of the specimen confirmed AGC. Colonoscopists should include AGC in the differential diagnosis of anal canal mass and rule out of malignancy. Excision is recommended for definitive diagnosis and treatment.