Many researches have been reported that collagen as cellular stroma, matrix of grafting materials, mediator of agents for the purpose of promoting healing process in vivo, but the responses in vivo were seen various. The goal of this experiment is to assess the effect of collagen on bony healing, through histological evaluation of implanted collagen on the calvarial defect in rats. 2-month-old Sprague-Dawley, 24 rats were used and 12 rats assigned to each group of control and test. Defect of 5mm in diameter was made on the calvarial bone with trephine bur. Following thorough saline rinse, defect of control group was left in empty and that of experimental group was filled with fibrillar collagen(COLLATAPE(R), COLLA-TEC. INC. U.S.A.) soaked in saline. 3 rats in each group were sacrificed at 3, 7, 14, 21 days after operation respectively, and the tissue blocks were prepared for light microscope with H-E for evaluation of overall healing, with TRAP(tartrate resistant acid phosphatase) for evaluation of osteoclastic activity and with immunohistochemical staining for macrophages. The results were as follows: 1. In the control group, inflammatory responses were disappeared at day 14, but, in the experimental group inflammatory infiltrates were reduced at day 21. Thus, the experimental group showed more severe soft tissue inflammation than control group. 2. Both control and experimental group showed slight appositional growth at day 7 and gradual bony growth to 21th day. But, complete bony healing of the defect was not shown. There was no significant difference in bony healing between control and experimental group 3. Specific response of macrophages for implanted collagen was observed at day 14 in the experimental group. In conclusion, although fibrillar collagen caused inflammation of soft tissue during initial healing period, inflammatory responses by fibrillar collagen didn't inhibit bony regeneration and implanted collagen was biodegradaded by macrophages. Thus, we expect that fibrillar collagen can be used for useful mediator of graft materials or growth factors.
Animals ; Collagen ; Fibrillar Collagens* ; Humans ; Infant ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Macrophages ; Osteoclasts ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transplants

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is a simple, safe and rapid method for the placement of a feeding gastrostomy tube and it is a well-established mean of providing enteral nutrition. Although it is frequently used in adults, there is limited experience for this procedure in children. METHODS: Twenty five procedures of PEG in 23 patients were performed in four institutions located in Youngnam province. We retrospectively reviewed our experiences of PEG. RESULTS: Fourteen males and nine females were included and their mean age was 5.7+/-4.1 years. The patients aged 1 to 6 years accounted for about a half the subjects. The underlying diseases of the patients were CNS disorders in all except one who was suffering with a neuromuscular disorder. The main reason for PEG was swallowing difficulty and the associated complications of the patients. Nasogastric tube feeding was the most common method of nutritional support before the procedures. The most common complication of PEG placement was wound infection. The patients' nutritional status after PEG placement was satisfactorily improved. The indwelling time of PEG tube was over 6 months in 2 of 3 patients and the tube was switched for a new one after a year. Removal of the tubes by using percutaneous traction was done in 2 of 3 patients. CONCLUSIONS: The PEG is a safe, easy to perform, and reliable technique to support enteral nutrition in children.
Adult ; Child* ; Deglutition ; Endoscopy ; Enteral Nutrition ; Female ; Gastrostomy* ; Humans ; Male ; Nutritional Status ; Nutritional Support ; Retrospective Studies ; Traction ; Wound Infection

OBJECTIVES: The purpose of this study is to evaluate the effects of a cognitive behavioral therapy (CBT)-based school bullying prevention program for the adolescent perpetrators of school violence. METHODS: total of 395 middle and high school students (male=316, female=79) were included in this study. The changes after the program were evaluated using several self-rating scales for the assessment of the degree of depression, loneliness, impulsivity, self-esteem, and interpersonal reactivity compared with the baseline scales. RESULTS: The school bullying prevention program significantly reduced the degree of depression severity (t=5.985, p<0.001) and increased the self-esteem (t=-2.67, p=0.008) of the teenagers. This tendency was more pronounced among those teenagers under the age of 16. In the participants with high impulsivity or low empathy at baseline, the impulsivity scale decreased (t=2.617, p=0.009), while the interpersonal reactivity scale increased (t=-3.364, p=0.001) after the program. CONCLUSION: The results of our study suggest that this CBT-based program developed for the prevention of school bullying can be effective in preventing further school violence. Further research to evaluate the long-term effects of the program is necessary.
Adolescent* ; Bullying ; Cognitive Therapy ; Depression ; Empathy ; Humans ; Impulsive Behavior ; Loneliness ; Violence* ; Weights and Measures

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) symptoms are associated with the deficit in executive functions. Playing Go involves many aspect of cognitive function and we hypothesized that it would be effective for children with ADHD. METHODS: Seventeen drug naive children with ADHD and seventeen age and sex matched comparison subjects were participated. Participants played Go under the instructor's education for 2 hours/day, 5 days/week. Before and at the end of Go period, clinical symptoms, cognitive functions, and brain EEG were assessed with Dupaul's ADHD scale (ARS), Child depression inventory (CDI), digit span, the Children's Color Trails Test (CCTT), and 8-channel QEEG system (LXE3208, Laxtha Inc., Daejeon, Korea). RESULTS: There were significant improvements of ARS total score (z=2.93, p<0.01) and inattentive score (z=2.94, p<0.01) in children with ADHD. However, there was no significant change in hyperactivity score (z=1.33, p=0.18). There were improvement of digit total score (z=2.60, p<0.01; z=2.06, p=0.03), digit forward score (z=2.21, p=0.02; z=2.02, p=0.04) in both ADHD and healthy comparisons. In addition, ADHD children showed decreased time of CCTT-2 (z=2.21, p=0.03). The change of theta/beta right of prefrontal cortex during 16 weeks was greater in children with ADHD than in healthy comparisons (F=4.45, p=0.04). The change of right theta/beta in prefrontal cortex has a positive correlation with ARS-inattention score in children with ADHD (r=0.44, p=0.03). CONCLUSION: We suggest that playing Go would be effective for children with ADHD by activating hypoarousal prefrontal function and enhancing executive function.
Attention Deficit Disorder with Hyperactivity* ; Brain* ; Child* ; Depression ; Education ; Electroencephalography ; Executive Function ; Humans ; Neurobehavioral Manifestations ; Prefrontal Cortex

OBJECTIVE: We aimed to examine the rates, correlates, methods, and precipitating factors of suicide attempts among adolescent patients admitted for psychiatric inpatient care from 1999 to 2010 in a university hospital in Korea. METHODS: The subjects consisted of 728 patients who were admitted for psychiatric inpatient care in a university hospital over a 12-year period and who were aged 10-19 years at the time of admission. We retrospectively investigated the information on suicidal behaviors and other clinical information by reviewing the subjects' electronic medical records. Whether these patients had completed their suicide on 31 December 2010 was determined by a link to the database of the National Statistical Office. RESULTS: Among 728 subjects, 21.7% had suicidal ideation at admission, and 10.7% admitted for suicidal attempts. Female gender, divorced/widowed parents, and the presence of mood disorders were associated with a significantly increased likelihood of suicide attempts. Most common method of suicide attempts was cutting, and most common reason for suicide attempts was relationship problems within the primary support group. A diagnosis of schizophrenia was associated with increased risk of death by suicide after discharge. CONCLUSION: These results highlight the role of specific psychosocial factor (e.g., relational problems) and psychiatric disorders (e.g., mood disorders) in the suicide attempts of Korean adolescents, and the need for effective prevention strategies for adolescents at risk for suicide.
Adolescent* ; Diagnosis ; Electronic Health Records ; Female ; Humans ; Inpatients* ; Korea ; Mood Disorders ; Parents ; Precipitating Factors* ; Psychology ; Retrospective Studies ; Risk Factors ; Schizophrenia ; Self-Help Groups ; Suicidal Ideation ; Suicide*

OBJECTIVES: To compare the white matter microstructure of dyslexic children with normal children using diffusion tensor imaging. METHODS: Twenty one dyslexic children and 24 normal control children were recruited in the second and third grade of elementary school students. The fractional anisotropy (FA) values of 20 representative white matter tracts were estimated from the diffusion tensor imaging data of each subject using the Johns Hopkins University-white matter tractography atlas to determine the difference in white matter integrity between the dyslexic children and normal children. RESULTS: Compared to the normal control group, the FA values of the left inferior longitudinal fasciculus [F(1,39)=5.908, p<0.05] and temporal part of the right superior longitudinal fasciculus [F(1,39)=7.328, p=0.010] were significantly higher in the dyslexic group and there was no significant difference in the other tracts. CONCLUSION: In dyslexic children, compensatory pathways develop in the left inferior longitudinal fasciculus and in the temporal part of the right superior longitudinal fasciculus.
Anisotropy ; Case-Control Studies ; Child ; Diffusion Tensor Imaging ; Dyslexia ; Humans ; White Matter

BACKGROUND: We evaluated all ambulatory surgeries conducted at our center using several factors (the utility rate and the number of ambulatory surgery, unanticipated admission and its reasons) in order to improve the performance of our facility. We hope that this data could be an indicator of ambulatory surgeries in Korea, which will help strengthen the basis for its development. METHODS: We investigated this study by utilizing the retrospective methods. Data were obtained from hospital records over a period of 5 years (January 2006 to December 2010) for patients who underwent day surgeries at our Day Surgery Center (DSC). RESULTS: The utility rate of ambulatory surgery was 20.38%, 20.91%, 17.03%, 16.73% and 17.70% from 2006 to 2010 each year. The total number of ambulatory surgeries performed in our DSC from 2006 to 2010 was 6875, 7168, 7423, 7417 and 7798 for each year. The unanticipated admission rate were 19 patients (0.57%), 30 patients (0.93%), 20 patients (0.62%), 46 patients (1.26%) and 48 patients (1.25%), respectively. The major causes of admission were due to surgeon request and wish of patients. CONCLUSIONS: In the review of our DSC, although the number of ambulatory cases have been increased from 6875 to 7798, the trend of the utility rate of ambulatory surgery is slightly downward from 20.38% to 17.70% for the recent 5 years. All of the unanticipated admission rate per year was below 1.5% and most of the reasons of the unanticipated admission after ambulatory surgery were non-medical.
Ambulatory Surgical Procedures ; Hospital Records ; Humans ; Korea ; Retrospective Studies

Facial appearance is influenced by the anatomic relationship of the eyebrow and eyelid. The morphology and normal anatomical value of upper eyelids are variable depending on race, sex and age, and have not been standardized yet in Korea. The authors statistically analysed normal anatomical variation of the upper eyelid morphology of 200 eyes of Koreans who had no surgery or trauma in the upper eyelid. One hundred men and one hundred women were included in this study. Physical examination of upper eyelid morphology included upper eyelid height, presence of upper eyelid crease and its level, height and width of palpebral fissure, height of tarsal plate, intercanthal distance, levator function, and presence of epicanthal fold with type. Average age was 21.09 in men and 23.03 in women, average heights of upper eyelid 15.04 mm and 16.05 mm, average heights of palpebral fissure 8.12 mm and 9.08 mm, average width of palpebral fissure 26.55 mm and 28.02 mm, average heights of tarsal plate 7.62 mm and 8.07 mm, and average intercanthal distances 36.82 mm and 35.90 mm. Increased values were noted in women compared to men, in upper eyelid height, height and width of palpebral fissure, and height of tarsal plate, especially levator fuction.But we couldn't find the statistical variation. Upper eyelid crease was noted in 29% in men, 54%in women.29 eyes in men and 24 eyes in women had epicanthal fold with epicanthus tarsalis being most prevalent morphologically. In our study, there was no meaningful difference of upper eyelid morphology depend on sex and we found that the favorate upper eyelid crease shape was the parallel crease type with narrow height in Koreans. These results may be beneficial in making a basic plan for the upper eyelid surgery such as blepharoplasty.
Blepharoplasty ; Continental Population Groups ; Eyebrows ; Eyelids* ; Female ; Humans ; Korea ; Male ; Physical Examination

BACKGROUND: The estrogen receptor (ER) in breast cancer specimens has traditionally been assessed using a biochemical ligand binding assay (LBA). Recently, the application of an immunohistochemical method (IHC) for formalin-fixed breast carcinoma tissue has greatly increased. Controversy exists over the accuracy of IHC compared with that of LBA in determining ER. METHODS: Breast-carcinoma tissues were obtained from 247 patients. ER was determined within 1 week or at 4 weeks after surgery by using the traditional LBA and by using IHC with monoclonal antibodies. The ER status was assessed with respect to age, size of tumor, and stage according to the two methods. RESULTS: The concordant rate of ER status was 75% between IHC and LBA. IHC-negative/LBA- positive results occurred in 31 cases (13%) and IHC-positive/LBA-negative were observed in 30 cases (12%). ER-positive cases were more common in older patients. The disconcordant rate was much higher in premenopausal females. There was a significantly lower ER positivity in tumors of larger than 5 cm. ER positivity was significantly lower at 4 weeks compared to within 1 week in both methods, but this did not change the concordance rate between the two methods. CONCLUSIONS: The ER-IHC method appears to be a reasonable substitute for a biochemical ligand binding assay. This is based on a 75% concordance of the method as well as on the findings in the disconcordant cases. The appropriate measured time for ER was within 1 week after the cancer tissues were obtained.
Antibodies, Monoclonal ; Biochemistry ; Breast Neoplasms* ; Breast* ; Estrogens* ; Female ; Humans ; Immunohistochemistry

OBJECTIVE: Recent studies of online game addiction have suggested that social interaction and impulsivity are critical factors for the etiology and progress of online game addiction. We hypothesized that the genre of the online game is associated with impulsivity and sociality in individuals with online game addictions. METHODS: In total, 212 patients with problematic online game playing were divided into four groups by game genre: 1) massive multiplayer online role playing game (MMORPG), 2) real-time strategy (RTS), 3) first-person shooter (FPS), and 4) other. Their symptoms and characteristics were assessed using 8 scales and 2 tests to estimate self-esteem, impulsiveness, comorbidity, social interaction status, and cognitive function. RESULTS: The mean social anxiety score was highest in the MMORPG group and lowest in the FPS group. The mean self-esteem score was highest in the RTS group. Social anxiety score was positively correlated with Internet addiction score in the MMORPG group, and the self-esteem score was positively correlated with Internet addiction score in the RTS group. CONCLUSION: The genre of online game was not associated with impulsivity, but social anxiety status varied significantly with game genre, and differences in social anxiety were especially pronounced in patients playing the MMORPG (highest social anxiety) and FPS (lowest social anxiety) game genres. In addition, self-esteem was highest in the RTS game genre.
Anxiety* ; Comorbidity ; Humans ; Impulsive Behavior* ; Internet ; Interpersonal Relations ; Role Playing ; Weights and Measures