PURPOSE: The purpose of the study was to develop an emotional self-regulation program for obese children and to examine the program's effectiveness on depression, eating habits, and body mass index. METHODS: The emotional self-regulation program was developed from theory-based strategies and a pre-post pilot study was conducted with 46 children (19: intervention, 27: control). The program included 6 weekly group sessions over 2 months. The embedded experimental model of concurrent mixed methods was used to better understand research outcomes by converging both quantitative and qualitative data. Anthropometric measurements and surveys were performed before and after the intervention. Three focus group interviews were conducted with all participants after intervention to explore their experiences. RESULTS: The intervention group displayed decreased depression levels in the quantitative outcomes. The participants also expressed positive outcomes such as improvements in confidence, impulse management, intimacy, happiness, and losing weight. CONCLUSION: These findings suggest that emotional self-regulation skills are crucial factors for obese children not only to manage their emotional problems but also to control their weight. Further research is needed with a larger sample size and randomized controlled trials.
Child ; Depression ; Eating ; Focus Groups ; Happiness ; Humans ; Models, Theoretical ; Obesity ; Pilot Projects ; Sample Size ; Self-Control

The incidence of fetal cardiac arrhythmia is approximately 1-3%. Sustatined fetal tachyarrhythmia may cause fetal hydrops and rnay lead to fetal death. We experienced a case of fetal atrial flutter without fetal hydrops at 34 weeks of gestation, which was diagnosed by fetal echocardiography. Transplacental fetal therapy with maternal digoxin administration resulted in restoration of normal fetal sinus rhythm. At birth, the infant showed normal electrocardiographic finding with normal Apgar scores.
Arrhythmias, Cardiac ; Atrial Flutter* ; Digoxin ; Echocardiography ; Electrocardiography ; Fetal Death ; Fetal Therapies ; Humans ; Hydrops Fetalis ; Incidence ; Infant ; Mothers* ; Parturition ; Pregnancy ; Tachycardia

OBJECTIVES: Though gastric cancer is one of the most common cancer in Korea, there have been few studies to explore psychological distress in gastric cancer. The purpose of this study was to investigate the prevalence and associated risk factors of psychological distress among patients with gastric cancer. METHODS: With consecutive sampling, a total of 274 patients with gastric cancer who admitted to a cancer center in a general hospital were recruited and assessed on psychological distress using the Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer-related clinical variables were also evaluated. RESULTS: One hundred fifty-three(55.8%) patients with gastric cancer showed psychological distress. Logistic regression models revealed that having alcohol drinking experience[odds ratio(OR)=2.10, p=0,034] and low performance status(OR=2.40 p=0.002) were significantly associated with psychological distress in patients with gastric cancer. CONCLUSIONS: These findings indicate that approximately half of patients with gastric cancer suffered from psychological distress and having alcohol drinking experience and low performance status would be associated risk factors, suggesting the need for distress screening and psychosocial supportive care in patients with gastric cancer.
Alcohol Drinking ; Anxiety ; Depression ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Mass Screening ; Prevalence ; Risk Factors ; Stomach Neoplasms

The objective of this study was to determine how the neonatal mortality rate has changed since surfactant (S) therapy was introduced in our Neonatal Intensive Care Unit (NICU), and to evaluate the efficacy of surfactant therapy in respiratory distress syndrome (RDS) patients. Incidences of risk babies such as outborns, prematurity, low birth weight infants and RDS, and neonatal mortality rates were compared between 'pre' (control, 1988 to 1991, n=4,861) and 'post' S period (study, 1993 to 1996, n=5,430). In RDS patients of 'post' S period, neonatal mortality rate was compared between S-treated and non-treated patients, and chest X-ray and ventilatory parameters were compared between pre- and post-72 hr of surfactant treatment. Surfactant therapy showed short term effects, judging by the decrease of early neonatal deaths and improvement of chest X-ray and ventilatory parameters in RDS patients. The overall neonatal mortality rate had a tendency to decrease in spite of increased incidences of risk babies in 'post' S period but it was less than expected. The reasons were thought to be that we had a high proportion of risk babies, and there was some bias in patient selection for surfactant therapy and its use. In conclusion, with the active prevention of risk baby delivery and appropriate use of surfactant, better results could be expected.
Female ; Human ; Incidence ; Infant Mortality ; Infant, Newborn ; Male ; Pulmonary Surfactants/therapeutic use* ; Respiratory Distress Syndrome/mortality* ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/drug therapy* ; Risk Factors

Subaortic stenosis usually occurs without a previous heart operation, however, it can occur after heart surgery as well, with a condition known as a secondary subaortic stenosis (SSS). SSS has been reported after surgical repair of several congenital heart defects. There are only a few recorded cases of SSS after repair of ventricular septal defect (VSD). Here we report a rare case of SSS that occurred 3 years after surgical repair of subarterial VSD. A follow-up echocardiogram is essential for detecting SSS caused by the newly developed subaortic membrane in patients who had cardiac surgery.
Constriction, Pathologic ; Discrete Subaortic Stenosis ; Echocardiography ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Membranes ; Thoracic Surgery

PURPOSE: To compare audio-only biofeedback to conventional audiovisual biofeedback for regulating patients' respiration during four-dimensional radiotherapy, limiting damage to healthy surrounding tissues caused by organ movement. MATERIALS AND METHODS: Six healthy volunteers were assisted by audiovisual or audio-only biofeedback systems to regulate their respirations. Volunteers breathed through a mask developed for this study by following computer-generated guiding curves displayed on a screen, combined with instructional sounds. They then performed breathing following instructional sounds only. The guiding signals and the volunteers' respiratory signals were logged at 20 samples per second. RESULTS: The standard deviations between the guiding and respiratory curves for the audiovisual and audio-only biofeedback systems were 21.55% and 23.19%, respectively; the average correlation coefficients were 0.9778 and 0.9756, respectively. The regularities between audiovisual and audio-only biofeedback for six volunteers' respirations were same statistically from the paired t-test. CONCLUSION: The difference between the audiovisual and audio-only biofeedback methods was not significant. Audio-only biofeedback has many advantages, as patients do not require a mask and can quickly adapt to this method in the clinic.
Biofeedback, Psychology* ; Feedback, Sensory ; Healthy Volunteers ; Humans ; Masks ; Radiotherapy* ; Respiration* ; Volunteers

The most cornmon obstruction of left ventricular outflow in childhood is produced either by a fibrous ring below the aortic valve, or by localized or diffuse muscular hypertrophy of the inter-ventricular septum. Cardiac tumors causing subaortic stenosis in the newborn infant are extremely rare. This report describes two cases of subaortic stenosis caused by a tumor of the left ventricle in newborn infants, both diagnosed by 2-dimensional echocardiography. In one patient, the obstructive portion of the tumor was successfully resected from its attachment to the ventricular septum by aortotomy on day 5. Histologic examination confirmed the diagnosis of rhabdomyoma. This patient developed cutaneous, neurologic and radiologic abnormalities of tuberous sclerosis during the follow-up of 42 months.
Aortic Valve ; Constriction, Pathologic* ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Neoplasms ; Heart Ventricles ; Humans ; Hypertrophy ; Infant, Newborn* ; Rhabdomyoma ; Tuberous Sclerosis ; Ventricular Septum

PURPOSE: To report a case of bilateral Coats' disease. CASE SUMMARY: A 19-month-old boy presented with esodeviation of his eyes, which started 5 months prior. A fundus exam showed total bullous exudative retinal detachment with retinal vascular telangiectasia in the right eye and localized exudative retinal detachment with vascular telangiectasia at the inferior periphery in the right eye. Fluorescein angiogram of the left eye showed retinal telangiectatic vessels, avascular area and fluorescein leakeage from telangiectatic vessels. The patient received external drainage of subretinal fluid and intravitreal air injection of the right eye and Argon LASER photocoagulation and cryotheraphy of the left eye. A cytologic exam of the subretinal fluid drained from the right eye showed no malignant cells. Forty-four months after the operation, his best corrected visual acuity was no light perception in the right eye and 0.4 in the left eye. Both fundi were flat and stable. No complications, such as glaucoma, recurred retinal detachment, or pain, occurred. CONCLUSIONS: Coats' disease rarely occurs bilaterally and can be involved asymmetrically. The disease presents more severely when bilateral and can progress after long-term observation. Proper treatment and long-term follow-up of both eyes are necessary to prevent visual loss and preserve eyes.
Argon ; Drainage ; Esotropia ; Eye ; Fluorescein ; Follow-Up Studies ; Glaucoma ; Humans ; Infant ; Light ; Light Coagulation ; Retinal Detachment ; Retinaldehyde ; Subretinal Fluid ; Telangiectasis ; Visual Acuity

Purpose: In this study, we assessed the intake of nutrients and food groups and analyzed the nutrition quotient of obese children in South Korea. The hypothesis was that dietary quality and nutrient intake are related to the body mass index (BMI) of obese children. Methods: The participants included 48 children (20 boys and 28 girls). Based on the guidelines for the age-for-body mass index provided by the Korean National Growth Charts for children and adolescents, the participants were divided into 3 groups: overweight, BMI ≥ 85th percentile; obese, BMI ≥ 95th percentile; severely obese, BMI ≥ 99th percentile. Results: The energy distribution showed that the carbohydrate ratio was significantly higher in the overweight group (p < 0.01), whereas the fat ratio was significantly higher in the obese and severely obese groups (p < 0.05). Thus, in the overweight and obese groups, the percent body fat was negatively associated with the carbohydrate ratio (p < 0.05) but was positively associated with the fat ratio (p < 0.05). The Dietary Reference Intakes (DRI) data revealed that the intake levels of protein, vitamin B 1 , vitamin B 12 , and sodium were higher in all groups. Intakes of fiber, calcium, potassium, and magnesium were insufficient in all groups, and the DRI percent for protein was significantly higher in the obese and severely obese groups than in the overweight group. No significant differences were obtained in food group patterns or Nutrition Quotient (NQ) scores among the 3 groups. According to the evaluation results by food record and NQ, a significant difference was obtained in the dietary quality of obese children. Conclusion We conclude that a higher intake of fat enhances weight gain. Based on the study results, we propose that the guidelines should consider the energy distribution of carbohydrate and fat intake to prevent and control obesity among Korean children.

Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.
Adolescent ; Cardiac Tamponade* ; Diagnosis ; Dyspnea ; Hashimoto Disease* ; Humans ; Hypothyroidism ; Male ; Noonan Syndrome* ; Pericardial Effusion ; Pericardial Window Techniques ; Thorax ; Thyroiditis, Autoimmune ; Thyroxine ; Vital Signs