OBJECTIVES: The aims of this study were to develop the Korean version of Adolescent Symptom Checklist(ASC) which was devised by Thomas et al.(1988), to investigate descriptive data of somatic symptoms which our adolescents reported and to find the correlation between somatic symptom and self-esteem. And furthermore we compared our results with those of foreign countries. METHOD: The subject group was composed of 794 students who go to commercial or academic high school in kwangju city. They completed self rating questionnaires which include ASC, Self-esteem scale and somatization and depression subscales of SCL-90-R. The descriptive statistics, reliability and validity of ASC, means of somatic symptom and self-esteem for each group and correlation of somatic symptom and self-esteem were examined. We would consider an adolescent as belonging to high risk group if their score on the ASC was one or more standard deviations above the mean. RESULTS: Seventeen point eight percent of all subjects were in high risk group and the pacentage was higher than 11-15% of foreign countries. Sixty nine point four percent had visited to hospital due to their somatic symptoms during the past 12months and 26.2% were treated by doctors recently. Internal consistency(Cronbach a .89) was high. Inter-item correlations were all positive and ranged from .09 to .58 with a mean of .29 and item-total correlations varied from .35 to .60 with a mean of .48. The ASC was significantly correlated with the somatization and depression subscales of SCL-90-R. Somatic symptoms of female group were much more frequent than those of male group. The higher their grade is, the more somatic symptoms they complained. There were signiticant negative correlations between somatic symptoms and self-esteem in all groups. CONCLUSION: By the result of this study, we suggest that ASC can be used as a tool for evaluation of adolescent's somatic symptoms. We showed that the frequency of somatic symptoms in adolescents were higher in females than in males, and were higher in upper grade than in lower grade. We also showed that the more somatic symptoms they complained, the lower self-esteem they had.
Adolescent* ; Depression ; Female ; Gwangju ; Humans ; Male ; Surveys and Questionnaires ; Reproducibility of Results

BACKGROUND: Evaluation of blunt abdominal trauma is clinically challenging. Diagnostic peritoneal lavage (DPL) and computed tomographic (CT) scanning have become primary diagnostic modalities. We examined the efficacy and the role of ultrasonographic (US) studies in the initial abdominal evaluation of blunt abdominal trauma. METHODS: We, therefore, retrospectively reviewed 87 patients who sustained blunt abdominal trauma from October 1996 to August 1997. RESULTS: Ultrasonography showed a sensitivity of 89.7% and a specificity of 98.3%. The accuracy was 95.4%. The positive predictive value was 96.3%, and the negative predictive value was 95.0%. CONCLUSIONS: Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the best method of first choice in the evaluation of blunt abdominal trauma. We believe that abdominal US should be considered an important tool and an integral part in the work-up for major trauma victims.
Emergencies* ; Emergency Service, Hospital ; Humans ; Peritoneal Lavage ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

Two patients, bulging fetal membrane accompanied with cervical dilatation & effacement in the late second-trimester, were treated by modified Shirodkar method. Pregnancies were prolonged effectively and viable fetuses were delivered in both cases. Our cases may help make objective decision prior to attempting cerclage placement when cervix is markedly dilated and something should be done to save pregnancy.
Cervix Uteri ; Extraembryonic Membranes* ; Female ; Fetus ; Humans ; Labor Stage, First ; Pregnancy ; Uterine Cervical Incompetence*

Renal cell carcinoma (RCC) is rare relative to other urological cancers, but relatively common overall among males. Even when primary tumors are successfully removed by surgery, metastases are often noted within a few years. On the other hand, masses found at other sites in patients with RCC may represent different primary cancers. We present the case of a 63-year-old man with a right lung mass and a left lung nodule who underwent radical right nephrectomy for RCC. We found no local recurrence of RCC in the abdomen. Despite treatment for RCC, the right lung mass increased in size. We performed a lung needle biopsy and diagnosed primary lung cancer. Postoperatively, the remaining left lung nodule also increased in size. It was diagnosed as an RCC metastasis upon biopsy and removed by wedge resection. The patient was treated with everolimus after the second surgery.
Abdomen ; Biopsy ; Biopsy, Needle ; Carcinoma, Bronchogenic ; Carcinoma, Renal Cell* ; Hand ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence ; Urologic Neoplasms ; Everolimus

PURPOSE: The purpose of teaching cardiopulmonary resuscitation (CPR) to laypersons is to give them the confidence and willingness to perform CPR in a real cardiac arrest, as well as the basic required knowledge and skills. However, no study has examined laypersons' confidence and willingness to act in a real, life-threatening situation. Therefore, we investigated the effects of CPR education on bystanders' confidence and attitude in performing bystander CPR. METHODS: From March to May 2008, 168 participants receiving 4 hours of CPR education were asked using a questionnaire about their confidence and willingness to perform bystander CPR before the education, after theoretical education, and after practical education. Those who answered that they wouldn't perform bystander CPR were asked for the reasons. RESULTS: Scores in confidence of bystander CPR were 50.4 +/-27.9 before the education, 64.9+/-22.5 after the theoretical education, and 79.5+/-16.1(p<0.001) after the practical education. The 'definitely yes' answer to 'willingness to perform CPR on a strange adult', increased from only 8.3% before the education to 18.5% after the theoretical education and 32.7% after the practical education (p<0.001). Among the reasons for not performing bystander CPR, 'fear of poor knowledge/performance' and 'fear of disease transmission' seemed to decrease as the education was carried on. However, the reasons 'fear of legal liability' and 'reluctance to perform mouth-to-mouth' showed no significant difference. CONCLUSION: Adequate education, including theoretical and practical CPR education, among laypersons significantly increased their confidence and willingness to perform bystander CPR.
Cardiopulmonary Resuscitation ; Heart Arrest ; Surveys and Questionnaires

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.
Congenital Abnormalities ; Diagnosis ; Facial Asymmetry ; Humans ; Jaw ; Jaw Fractures ; Malocclusion* ; Osteotomy ; Temporomandibular Joint

A retrospective clinical study to evaluate the use of the argon and Nd: YAG laser in sequential combination for iridotomy was carried out on 29 eyes of 19 patients with angle closure glaucoma. The argon laser settings were standardized at 0.01-0.02 second duration and 50 micrometerspot size. The total mean energies for the argon and Nd: YAG stages were 2.7 +/-1.49J and 9.0 +/-5.83 mJ respectively. Mean postoperative decrease of intraocular pressure(IOP)was 26.4 +/-20.14 mmHg. Postoperative complications were bleeding at iridotomy site (3 eyes),transient increse in IOP (2 eyes),and posterior synechia (1 eye),but there was no lenticularopacity,and no closure of the iridotomy site. The laser iridotomy using sequential argon and Nd: YAG laser is an effective method in dark irides, lowering the mean total energy delivered per eye by the argon and YAG laser repectively, combining the advantages of both laser procedures while avoiding most of the disadvantages. We think that it is the more safe and effective method with the decreased mean total energy of argon laser at 0.01-0.02 second duration, 50 micrometerspot size followed by YAG laser.
Argon* ; Glaucoma, Angle-Closure* ; Hemorrhage ; Humans ; Lasers, Solid-State* ; Postoperative Complications ; Retrospective Studies

BACKGROUND: Extracellular K+ concentration ([K+]o) can be increased within several mM by the efflux of intracellular K+. To investigate the effect of an increase in [K+]o on vascular contractility, we attempted to examine whether extracellular K+ might modulate vascular contractility, endothelium-dependent relaxation (EDR) and intracellular Ca2+ concentration ([Ca2+]i) in endothelial cells (EC). MATERIAL AND METHOD: We observed isometric contractions in rabbit carotid, superior mesentery, basilar arteries and mouse aorta. [Ca2+]i was recorded by microfluorimeter using Fura-2/AM in EC. RESULT: No change in contractility was recorded by the increase in [K+]o from 6 to 12 mM in conduit artery such as rabbit carotid artery. whereas resistant vessels, such as basilar and branches of superior mesenteric arteries (SMA), were relaxed by the increase. In basilar artery, the relaxation by the increase in [K+]o from 1 to 3 mM was bigger than that by the increase from 6 to 12 mM. In contrast, in branches of SMA, the relaxation by the increase in [K+]o from 6 to 12 mM is bigger than that by the increase from 1 to 3 mM. Ba2 (30microM) did not inhibit the relaxation by the increase in [K+]o from 1 to 3 mM but did inhibit the relaxation by the increase from 6 to 12 mM. In the mouse aorta without the endothelium or treated with NG-nitro-L-arginine (30microM), nitric oxide synthesis blocker, the increase in [K+]o from 6 to 12 mM did not change the magnitude of contraction induced either norepinephrine or prostaglandin F2alpha. The increase in [K+]o up to 12 mM did not induce contraction of mouse aorta but the increase more than 12 mM induced contraction. In the mouse aorta, EDR was completely inhibited on increasing [K+]o from 6 to 12 mM. In cultured mouse aorta EC, [Ca2+]i was increased by acetylcholine or ATP application and the increased [Ca2+]i was reduced by the increase in [K+]o reversibly and concentration-dependently. In human umbilical vein EC, similar effect of extracellular K+ was observed. Ouabain, a Na+-K+ pump blocker, and Ni2 , a Na+-Ca2+ exchanger blocker, reversed the inhibitory effect of extracellular K+. CONCLUSION: In resistant arteries, the increase in [K+]o relaxes vascular smooth muscle and the underlying mechanisms differ according to the kinds of the arteries; Ba2 -insensitive mechanism in basilar artery and Ba2 -sensitive one in branches of SMA. It also inhibits [Ca2+]i increase in EC and thereby EDR. The initial mechanism of the inhibition may be due to the activation of Na+-K+ pump.
Acetylcholine ; Adenosine Triphosphate ; Animals ; Aorta ; Arteries ; Basilar Artery ; Calcium ; Carotid Arteries ; Dinoprost ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Humans ; Isometric Contraction ; Mesenteric Artery, Superior ; Mesentery ; Mice ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroarginine ; Norepinephrine ; Ouabain ; Potassium ; Relaxation* ; Umbilical Veins ; Vasodilation

Background: We compared the effects of palonosetron with ondansetron for preventing postoperative nausea and vomiting (PONV) during the first 24 h after surgery in women receiving intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control. Methods: In this prospective, randomized, double-blinded study, 204 healthy patients who were undergoing elective surgery with general anesthesia were enrolled. In the palonosetron group (n = 102), 0.075 mg bolus was given intravenously (i.v.) 30 min before the end of surgery and 8 ml saline was added to the IV-PCA. In the ondansetron group (n = 102), 8 mg bolus i.v. was given 30 min before the end of surgery and 16 mg of ondansetron was added to the IV-PCA. The incidence of PONV, severity of nausea, and use of rescue anti-emetics were evaluated 6 and 24 h after the operation. Results: The incidences of nausea (55.6%) and vomiting (14.1%) in the palonosetron group did not differ from those (58.3 and 19.8%) in the ondansetron group during the first 24 h after surgery (P > 0.05). No significant differences were observed in the severity of nausea and use of rescue anti-emetics between the two groups (P > 0.05). Conclusions The effects of palonosetron in preventing PONV were not different from those of ondansetron during the first 24 h postoperatively in women receiving IV-PCA with fentanyl.

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial lung biopsy confirmed primary lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother's brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with lung cancer.
Adenocarcinoma ; Adult ; Anoxia ; Biopsy ; Brain ; Chemoradiotherapy ; Child ; Cough ; Emergencies ; Fetal Distress ; Humans ; Lung ; Lung Neoplasms ; Mothers ; Neoplasm Metastasis ; Parturition ; Pregnancy ; Pulmonary Atelectasis ; Rare Diseases ; Smoke ; Smoking ; Thorax