PURPOSE: The etiology of febrile seizures is not yet ascertained but it is known that genetic factors, cytokines or trace elements are associated with pathogenesis of febrile seizures. Among them, zinc deficiency is known to play some role of pathogenesis of febrile seizures. We purposed to know the relation between recurrence of febrile seizures and serum zinc level. METHODS: The subjects were recurrent febrile seizures group who were admitted to our hospital from June 2003 to July 2005 because of more than 3 times febrile seizures. The other two control groups were simple febrile seizures and acute febrile illness groups admitted to our hospital in same period. Simple febrile seizures group showed no more seizure over 1 year after first onset. We investigated serum zinc level in each group. RESULTS: The number of patient in each group is 33 children. Recurrent febrile seizures group was composed of 20 boys and 13 girls (the ratio of 1.5:1) with an average age 30 months old. The mean serum zinc levels in the recurrent febrile seizures group (123.7+/-9.6 microgram/dL) were not statistically different from those of the simple febrile seizures group(112.5+/-8.9 microgram/dL). Both of the recurrent and simple febrile seizures groups had significantly lower serum zinc levels than the febrile illness group(154.1+/-6.8 microgram/dL). CONCLUSION: We suggested that serum zinc level is not relationship with recurrence of febrile seizures. Nevertheless, the fact remains that serum zinc level was decreased in recurrent and simple febrile seizures groups compared with acute febrile illness group.
Child ; Child, Preschool ; Cytokines ; Female ; Humans ; Recurrence* ; Seizures ; Seizures, Febrile* ; Trace Elements ; Zinc*

BACKGROUND: Nitrous oxide is a safe analgesics which has analgesic and sedative effects without loss of consciousness. The advantage of Nitrous oxide is that it has a rapid onset time and that we can modulate duration of its action. The purpose of this experiment is to obtain the safe and effective concentration of Nitrous oxide in Emergency Department as use of analgesics and sedative drugs. METHODS: Twenty volunteers were investigated according to double blind method. Nitrous oxide was administrated to volunteer subjects at different concentrations ; 33%, 50%, 67% each. Then we evaluated the Pain score, Blood pressure, Heart rate, Respiratory rate, Oxygen saturation and its side effects. RESULTS: Pain Score were 8.4+/-2.1 at 33%, 6.1+/-1.5 at 50%, and 3.65+/-2.2 at 67% of Nitrous oxide. Pain Score is decreased significantly following administration of Nitrous oxide at concentration of 50%, 67%(P<0.05). There was no difference between preadministration group and postadministration group. While no remarkable change in systolic blood pressure, heart rate, and oxygen saturation. Respiratory rate showed significant increase when 679o of Nitrous oxide was administrated. There was no side effect in administration of 33% of Nitrous oxide. When 50% of Nitrous oxide was administrated, there were dizziness 5(25%), paresthesia 2(10%), nausea 1(5%), palpitation 1(5%) and hyperethesia 1(5%). At 679o of Nitrous oxide, there were nausea 7(35%), dizziness 6(30%), paresthesia 5(25%), headache 5(25%), diplopia 2(10%), dysphoria 2(10%), salivation 1(5%), dyspnea 1(5%), nystagmus 1(5%), tinnitus 1(5%) and euphoria1 (5%). Incidence of side effect increased as the concentration of Nitrous oxide was increased. CONCLUSION: We can conclude that safe and effective concentration of Nitrous oxide is 50% as analgesics and sedative drugs in the emergency department.
Analgesics ; Blood Pressure ; Diplopia ; Dizziness ; Double-Blind Method ; Dyspnea ; Emergency Service, Hospital ; Headache ; Heart Rate ; Hemodynamics* ; Hypnotics and Sedatives ; Incidence ; Nausea ; Nitrous Oxide* ; Oxygen ; Paresthesia ; Respiratory Rate ; Salivation ; Tinnitus ; Unconsciousness ; Volunteers

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The purpose of this study was to assess the interrelationship of maximal step length (MSL) measurement as protective strategies and risk factors of falls. METHODS: The study population consisted of 149 community-dwelling people (> or = 60 yrs). Demographic data, depression degree (GDS-short form), fatigue degree (revised Chalder's fatigue scale) were reviewed by self-recorded questionnaire. K-MMSE, MSL, US and TUG were done when they visited our clinic. We examined whether MSL was correlated with the six leg-directions and was related to other measures to evaluate fall risk. To examine the association between MSL and other variables, we analyzed data by T-test, ANOVA and multiple regressions. RESULTS: The MSLmean correlated highly with each leg- direction MSL (correlation coefficient, r=0.771~0.941, P<0.01), US (r=0.392, P<0.01) and TUG (r=-0.608, P<0.01). The MSL(mean/L) (MSL(mean), leg length adjusted) correlated strongly with frequent fall (P=0.005). Also, the MSL(mean/L) had a tendency to be low in the elderly, females, in those with regular exercise, widowed or divorced, DM, stroke, dementia suspicion, inclination toward depression, arthritis and frequent falls, but higher score on fatigue groups. Age (P<.001), sex (P=0.001), DM (P<.001), frequent falls (P= 0.017), dementia suspicion (P=0.016), and arthritis (P= 0.024) variables were related with MSL(mean/L) when we examined these variables by multiple regression analysis. CONCLUSION: MSL was correlated highly with other functional performance test and DM, age, sex, frequent fall, dementia suspicion, and arthritis variables for fall risk.
Adult ; Aged ; Arthritis ; Dementia ; Depression ; Divorce ; Fatigue ; Female ; Humans ; Leg ; Risk Factors ; Stroke ; Widowhood ; Surveys and Questionnaires

BACKGROUND: Many clinical measures have been used to assess fall risk in elderly adults. The purpose of this study was to assess the interrelationship of maximal step length (MSL) measurement as protective strategies and risk factors of falls. METHODS: The study population consisted of 149 community-dwelling people (> or = 60 yrs). Demographic data, depression degree (GDS-short form), fatigue degree (revised Chalder's fatigue scale) were reviewed by self-recorded questionnaire. K-MMSE, MSL, US and TUG were done when they visited our clinic. We examined whether MSL was correlated with the six leg-directions and was related to other measures to evaluate fall risk. To examine the association between MSL and other variables, we analyzed data by T-test, ANOVA and multiple regressions. RESULTS: The MSLmean correlated highly with each leg- direction MSL (correlation coefficient, r=0.771~0.941, P<0.01), US (r=0.392, P<0.01) and TUG (r=-0.608, P<0.01). The MSL(mean/L) (MSL(mean), leg length adjusted) correlated strongly with frequent fall (P=0.005). Also, the MSL(mean/L) had a tendency to be low in the elderly, females, in those with regular exercise, widowed or divorced, DM, stroke, dementia suspicion, inclination toward depression, arthritis and frequent falls, but higher score on fatigue groups. Age (P<.001), sex (P=0.001), DM (P<.001), frequent falls (P= 0.017), dementia suspicion (P=0.016), and arthritis (P= 0.024) variables were related with MSL(mean/L) when we examined these variables by multiple regression analysis. CONCLUSION: MSL was correlated highly with other functional performance test and DM, age, sex, frequent fall, dementia suspicion, and arthritis variables for fall risk.
Adult ; Aged ; Arthritis ; Dementia ; Depression ; Divorce ; Fatigue ; Female ; Humans ; Leg ; Risk Factors ; Stroke ; Widowhood ; Surveys and Questionnaires

This study aimed to investigate the associations between various types of childhood trauma and suicidal behavior in the general population in South Korea. This mental health survey included a total of 1,490 general citizens living in a metropolitan South Korean city who completed a questionnaire that assessed respondents’ histories of childhood trauma before the age of 12 years, including bullying victimization, emotional abuse, sexual abuse, and physical abuse, as well as suicidal behavior, including current suicidal ideation and histories of suicide planning and attempts. The following psychiatric scales were administered: Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (R-SES), Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and visual analogue scale of EuroQol 5D (EQ-5D). Participants who experienced any childhood trauma had significantly higher HADS and PSS scores, and significantly lower EQ-5D scores. Additionally, participants with any type of childhood trauma were significantly more likely to have current suicidal ideation and histories of planned and attempted suicide. Multivariate analyses adjusted for confounding variables indicated that bullying victimization and sexual abuse were associated significantly with all types of suicidal behavior. Physical abuse was associated significantly with histories of suicide planning and attempts. The present findings showed that any type of childhood trauma was associated with higher levels of suicidality, anxiety, depression, and perceived stress, as well as lower health-related quality of life, in the general population. In particular, associations between childhood trauma and suicidality were identified after adjustment for confounding variables.

This study aimed to investigate the associations between various types of childhood trauma and suicidal behavior in the general population in South Korea. This mental health survey included a total of 1,490 general citizens living in a metropolitan South Korean city who completed a questionnaire that assessed respondents’ histories of childhood trauma before the age of 12 years, including bullying victimization, emotional abuse, sexual abuse, and physical abuse, as well as suicidal behavior, including current suicidal ideation and histories of suicide planning and attempts. The following psychiatric scales were administered: Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale (R-SES), Connor-Davidson Resilience Scale (CD-RISC), Perceived Stress Scale (PSS), and visual analogue scale of EuroQol 5D (EQ-5D). Participants who experienced any childhood trauma had significantly higher HADS and PSS scores, and significantly lower EQ-5D scores. Additionally, participants with any type of childhood trauma were significantly more likely to have current suicidal ideation and histories of planned and attempted suicide. Multivariate analyses adjusted for confounding variables indicated that bullying victimization and sexual abuse were associated significantly with all types of suicidal behavior. Physical abuse was associated significantly with histories of suicide planning and attempts. The present findings showed that any type of childhood trauma was associated with higher levels of suicidality, anxiety, depression, and perceived stress, as well as lower health-related quality of life, in the general population. In particular, associations between childhood trauma and suicidality were identified after adjustment for confounding variables.

PURPOSE: Chondroid syringoma, previously known as 'mixed tumor of the skin', is a rare benign tumor. It usually presents an asymptomatic solitary firm intradermal or subcutaneous slowly growing nodule. It occurs frequently in the head and neck region of middle-aged men. We would like to report an uncommon chondroid syringoma about the clinical and histologic presentation. about the clinical and histologic presentation. METHODS: We experienced two cases of chondroid syringoma on the nose and the upper lip, each other. Both masses were totally excised with clear margin. RESULTS: On histologic examination, the masses showed a biphasic pattern-an epithelial component exhibiting apocrine/eccrine differentiation and a stromal component exhibiting myxoid/collagenous change-consistent with the diagnosis of chondroid syringoma. There have been no evidence of recurrence and malignant transformation during postoperative follow-up. CONCLUSION: There is no one distinctive clinical feature that is specific for chondroid syringoma. However, it should be included in the differential diagnosis of a solid nodule in head and neck region with long standing duration, such as epidermal inclusion cyst, pilomatrixoma, dermoid cyst, sebaceous cyst, neurofibroma, and basal cell carcinoma.
Adenoma, Pleomorphic* ; Carcinoma, Basal Cell ; Dermoid Cyst ; Diagnosis ; Diagnosis, Differential ; Epidermal Cyst ; Follow-Up Studies ; Head ; Humans ; Lip* ; Male ; Neck ; Neurofibroma ; Nose ; Pilomatrixoma ; Recurrence

PURPOSE: For facial reconstruction, skin color match is crucial to achieve great aesthetic result. Forehead flap and full thickness skin graft have been used for many years to reconstruct facial defect. Their results are aesthetically valuable with remarkable resemblance and harmony of the skin color between donor and recipient sites. The purpose of this study is to evaluate and compare the aesthetic outcome of the two methods as the analysis of skin color match. METHODS: From January 1995 to December 2005, ten forehead flaps and ten full thickness skin grafts were performed. The reconstructed areas of forehead flaps were five noses and five eyelids. Recipient sites of full thickness skin grafts were seven eyelids, two noses and one forehead. In order to obtain the objective validity, the skin color of flap(or graft) and the recipient sites were measured by chromameter. The skin colors were quantified according to a three-dimensional coordinate system used in chromameter, L*(brightness), a*(redness), and b*(yellowness). RESULTS: There was no significant color difference between forehead flap site and adjacent skin in all color values. On the other hand, the L* and b* values of graft sites were significantly lower than those of the adjacent skins. The a* values of graft sites were higher than those of the adjacent skins. CONCLUSION: This study reveals that skin color match of forehead flap is greater than that of full thickness skin graft. As forehead flap has adequate volume and great color match, it can be useful to reconstruct deep facial defect such as nasal defect. On the other hand, full thickness skin graft can be used for superficial defect like partial eyelid defect.
Eyelids ; Forehead ; Hand ; Humans ; Nose ; Skin ; Tissue Donors ; Transplants

PURPOSE: The popularity of a partial nephrectomy has grown as a consequence of the increased detection of small incidental renal masses. Herein, our experience of laparoscopic partial nephrectomies is reported. MATERIAL AND METHODS: Between December 2003 and April 2006, 27 cases underwent a laparoscopic partial nephrectomy for renal tumors up to 4cm in diameter. The tumors, and an approximate 0.5cm margin around the tumors, were resected with cold scissors. Hemostasis was achieved with freehand suturing of the pelvocalyceal system and renal parenchyme, over the surgical bolster, using fibrin glue. RESULTS: Transperitoneal and retroperitoneal approaches were chosen in 14 and 13 cases, respectively. Hilar clamping of small exophytic tumors was performed in all but 3 cases, with minimal parenchymal invasion. The mean renal tumor size was 2.5cm (ranging from 1 to 4cm). The mean operative and warm ischemia times, and blood loss were 193 minutes (ranging from 115 to 300) and 27.8 minutes (ranging from 15 to 43), and 493ml (ranging from 32 to 1,248), respectively. The mean hospitalization stay was 5.2 days (ranging from 3 to 8 days). Conversion to a laparoscopic radical nephrectomy was required in one case due to a positive frozen biopsy of the resection bed. There were no perioperative complications or open conversions. Histological examinations yielded a renal cell carcinoma in 20 cases, an angiomyolipoma or oncocytoma in 2 cases each, a lipoma in 1 and a leiomyosarcom in 2 cases, two of which had positive margins. One patient underwent selective angioembolization for an asymptomatic renal artery pseudoaneurysm three months postoperatively. All patients were alive, without any local recurrence or metastatic disease, at a mean follow up of 11.4 months (ranging from 3 to 24 months). CONCLUSIONS: A laparoscopic partial nephrectomy can be performed safely. However, long-term follow-up is required to compare its cancer control with that of an open partial nephrectomy.
Adenoma, Oxyphilic ; Aneurysm, False ; Angiomyolipoma ; Biopsy ; Carcinoma, Renal Cell ; Constriction ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Hemostasis ; Hospitalization ; Humans ; Kidney Neoplasms ; Laparoscopy ; Lipoma ; Nephrectomy* ; Recurrence ; Renal Artery ; Warm Ischemia

PURPOSE: To evaluate the treatment outcomes of the modified extension block technique for bony mallet finger. MATERIALS AND METHODS: This study included 16 patients who had been treated with the modified extension block technique for bony mallet finger from December 2002 to January 2004. The average duration of follow up was 13 (12~17) months. The indication of operation was the presence of a large bony fragment invading more than 1/3 of the articular surface or the palmar subluxation in the distal interphalangeal joint. RESULTS: The average extension lag was 2.3 degrees, and the range of motion of the distal interphalangeal joint was 68.8 degrees. Radiograph showed bony union state in all cases. By the Crawford's evaluation criteria, 12 cases (75%) was excellent or good. Postoperative complications occurred in 3 cases, which were reduction loss within postoperative 2 weeks in 2 cases and mild pain with motion in 1 case. CONCLUSION: The modified extension block technique is a easy and simple method. It shows a good result without complications from skin incision. So, it seems a useful method for bony mallet finger.
Fingers* ; Follow-Up Studies ; Humans ; Joints ; Postoperative Complications ; Range of Motion, Articular ; Skin