A clinical review was made on 2,191 cases of general pediatric surgery under the age of 15 years which were operated upon at the Divisionof Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The number of operations in pediatric age were 13,144 (13.2%) out of total 99,555 operations at Chonnam University Hospital and the most prevalent age group was under 1 year of age (14.3%). The number of operations in Divisionof General Pediatric Surgery were 2,191 (16.7%) out of total 13,144 operations in pediatric age and the incidence of patients under 1 year of age in general pediatric surgery was 42.9% (941/2,191). The prevalent diseases under 1 month of age were anorectal malformations (20.6%) and hypertrophic pyloric stenosis (20.3%) and between 1 month to 1 year of age were inguinal hernia (32.4%) and intussusception (19.6%). The total motality rate in neonatal intensive care unit was 31.3%. Gastroschisis presented highest mortality.
Gastroschisis ; Hernia, Inguinal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intussusception ; Jeollanam-do ; Mortality ; Pyloric Stenosis, Hypertrophic

PURPOSE: To evaluate the incidence and the site of osteomas and their relation to sinonasal inflammation. MATERIALS AND METHODS: 1578 PNS computed tomography (CT) of patients with symptoms of sinusitis were evaluated and correlation with plain radiographic finding was done. RESULTS: The total incidence of osteomas was 0.82%(13/1578) on plain radiography and 3.29% (52/1578) on CT. Fifty-seven osteomas were found in 1578 PNS CT, including 2 osteomas in 5 cases. The most common site was the ethmoid sinus(54%, 31/57) and the next was the frontal sinus(35%, 20/57) on CT. Forty-five osteomas (78.9%) were associated with the sinonasal inflammatory change. CONCLUSION: The total incidence of osteomas from our results was higher than previous reports. And based on the analysis of CT, the most common site was not the frontal sinus as all the previous reports stated, but the ethmoid sinus, probably by virtue of high resolution of CT and/or higher prevalence of inflammation in the ethmold sinus.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Incidence ; Inflammation ; Osteoma* ; Prevalence ; Radiography ; Sinusitis ; Virtues

OBJECTIVE: To estimate the self-esteem and to understand the psychosocial needs of people with cerebral palsy(CP). METHOD: Thirty-seven adult CP with age from 19 to 30 years and 24 controls with age from 19 to 33 years were evaluated for their self-esteems. The self-esteem was estimated by the standardized Korean-version of manual which was originally developed by Fitts(1965). RESULTS: The CP group scored significantly lower than the control group on 5 items of the physical self-esteem, personal self-esteem, self identity, self satisfaction, and self behavior among the 14 self-esteem items. Males scored higher than females on the personal self-esteem and self behavior. Personal self-esteem score was higher with the increasing age. The type of CP and the independent gait had no influence on the positive self. CONCLUSION: The differences on self-esteem between CP and control group suggest the needs of psychosocial support for the adults with cerebral palsy.
Adult* ; Cerebral Palsy* ; Female ; Gait ; Humans ; Male ; Self-Assessment

A statistical study of soldiers who visited the outpatient ciepartment of the Capital Armed Forces General Fiospital from 1987 to 1989 was performed. The results were as follows : 1. The total number of outpatients was 9969 with peak clinic visits in June(11.2%) and the lowest number of clinic visits in February(6.4% ). 2. The most frequent age was 22 years(20.7% ). Soldiers between 19 and 24 years old comprised 68.1% of total patients. 3. By rank 69.3% of the outpatients were private', 16.0% sergeant and 14,4% officers. 4. The most common dermatoses were dermatophytosis, contact dermatitis, scabies, acne, seborrheic dermatosis, urticaria, alopecia, condyloma acuminatum, verruca, folliculitis, psoriasis, insect bite reactions, pityriasis rosea, herpes zoster and corns. 5. Frequent diseases, which occured during summer season, included dermatophytosis, contact dermatitis and inser,t bites. The incidence of scabies, pityriasis prsea was increased during winter and that of psoriasis was increased during spring.
Acne Vulgaris ; Alopecia ; Ambulatory Care ; Arm ; Callosities ; Dermatitis, Contact ; Folliculitis ; Herpes Zoster ; Humans ; Incidence ; Insect Bites and Stings ; Military Personnel* ; Outpatients ; Pityriasis ; Pityriasis Rosea ; Psoriasis ; Scabies ; Seasons ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Warts ; Young Adult ; Zea mays

PURPOSE: Thyroid disease is the most common endocrine disease in childhood. Thyroid hormone has critical effects on growth and development, especially in childhood. We survey the prevalence, sex and age distribution, symptoms and thyroid function states of thyroid diseases in childhood. METHODS: Three hundred ninety one children who were diagnosed as having thyroid disease at department of pediatrics, St. Mary's hospital from Jan. 1987 to Dec. 1998 enrolled in this study. RESULTS: 1) The ratio between male and female patients was 1: 5.3. Age distribution was puberty, school age and infancy in their order of frequency. 2) The results of thyroid function tests showed normal function in 210 cases (53.7%), increased function in 95 cases(24.3%), and decreased function in 86 cases (22%). 3) Simple goiter, Graves disease, and chronic lymphocytic thyroiditis were the most common diseases in euthyroid, hyperthyroid, and acquired hypothyroid state, respectively. 4) The most common sign and symptom was goiter in euthyroid(100%), hyperthyroid(98.8%) and acquired hypothyroid state(96.2%). Forty of 68 cases(58.8%) with congenital hypothyroidism were detected by neonatal screening. CONCLUSION: Simple goiter, chronic lymphocytic thyroiditis and Graves disease were common acquired thyroid diseases in childhood, and goiter is the most common clinical manifestation in acquired thyroid disease. Recently, increasing number of congenital hypothyroidism was detected by neonatal screening test.
Adolescent ; Age Distribution ; Child ; Congenital Hypothyroidism ; Endocrine System Diseases ; Female ; Goiter ; Graves Disease ; Growth and Development ; Hashimoto Disease ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; Pediatrics ; Prevalence ; Puberty ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

We report a case of fixed-type sporotrichosis in a 12-month-old infant, who presented with a well-defined scaly erythematous patch on the right lateral nasal root area of approximately 2.5 months duration. Hiopsy revealed pseudoepitheliomatous hyperplasia with chronic granulomatous inflammation in dermis and PAS-positive fungal spores in the stroma. Sporothrix schenckii was identified with fungal culture of biopsy specimen. The lesion was responded to treatment. with itraconazole(3mg/kg) for 12 weeks, without relapse at 5-month follow-up.
Biopsy ; Dermis ; Follow-Up Studies ; Humans ; Hyperplasia ; Infant ; Inflammation ; Itraconazole ; Recurrence ; Spores, Fungal ; Sporothrix ; Sporotrichosis*

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

PURPOSE: Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS: Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS: There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION: Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Adult ; Education, Nursing, Baccalaureate ; Emergency Medical Services ; Female ; Heart Arrest/*nursing ; Humans ; Learning ; Male ; Manikins ; *Patient Simulation ; Students, Nursing/psychology

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

PURPOSE: Surgical site infections(SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl plus(R)(Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl plus(R)(Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. METHODS: We did a comparison of Vicryl plus(R) suture(with triclosan) size 2-0, 5-0 with Vicryl(R) suture(without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter baumanii, Escherichia coli, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at 37degrees C followed by zone of inhibition assay. RESULTS: Vicryl plus(R) group has demonstrated to create a zone of inhibition against MRSA, MSSA and A. baumanii, but no effect on E. faecalis, P. aeruginosa, C. albicans. Vicryl plus(TM) suture size 2-0 also had antibactericidal effect while Vicryl plus(R) suture size 5-0 did not. Vicryl(R) group had no zones of inhibition showing colonization at all mircroorganisms. CONCLUSION: Our results seem to warrant the use of Vicryl plus(R) as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.
Acinetobacter ; Agar ; Bacteria ; Candida albicans ; Colon ; Cross Infection ; Enterobacter ; Escherichia coli ; Methicillin-Resistant Staphylococcus aureus ; Obesity ; Operating Rooms ; Polyglactin 910 ; Pseudomonas aeruginosa ; Seeds ; Smoking ; Sprains and Strains ; Staphylococcus aureus ; Sutures ; Triclosan