A serum ferritin level is now the most sensitive and specific assay for iron deficiency. Incidence of iron deficiency anemia was determined by means of the serum ferritin level and the response to iron therapy, and changes in serum ferritin level were observed in 421 hospitalized pediatric patients with various diseases. The results were as follows : 1. Incidence of anemia was 45% of total hospitalized patients. Incidence of iron deficiency anemia was 5.9% of total patients and 13.3% of patients with anemia. It was most common between 6 moths and 2 years of age. 2. Serum ferritin levels were below 10ng/ml in 20(range;1-8.8ng/ml) and between 13.2 -24.5ng/ml in 5 out of 25 patients with iron deficiency anemia. Determination of the serum ferritin level, therefore, was thought to be an accurate method for the diagnosis of iron deficiency anemia. 3. Mean serum ferritin levels were 152.1ng/ml in total patients, 143.4ng/ml in patients without anemia, 7.9ng/ml in patient with iron deficiency anemia, and 199.9ng/ml in patients with anemia of other causes. Iron deficiency anemia was easily differentiated from the anemia of other causes by serum ferritin level. 4. Serum ferritin levels were elevated to significantly higher level in leukemia, aplastic anemia, rheumatoid arthritis, liver diseases and chronic infections.
Anemia ; Anemia, Aplastic ; Anemia, Iron-Deficiency* ; Arthritis, Rheumatoid ; Diagnosis ; Ferritins ; Humans ; Incidence ; Iron* ; Leukemia ; Liver Diseases ; Moths

BACKGROUND AND OBJECTIVES: To examine the chemopreventive effects of Ginkgo biloba extract (EGb 761) on oral cavity cancer, we investigated the apoptosis of oral cavity cancer cells by EGb 761 and the apoptotic pathway involved. MATERIALS AND METHOD: SCC 1483 cancer cell line derived from a human retromolar trigone carcinoma was used. Inhibition of proliferation was examined by proliferation assay. Apoptosis was measured and confirmed by flow cytometry, DNA fragmentation assay and Western blotting with PARP antibodies. The involvement of the caspase cascade was investigated by co-treating with the caspase inhibitor, z-VAD-fmk. RESULTS: The inhibition of SCC 1483 cells was noted from 250 microgram/ml of EGb 761. Apoptosis was observed after 24 hours of incubation with 250 microgram/ml EGb 761 and it occurred in a time-dependent manner. Apoptosis was confirmed by DNA fragmentation and PARP cleavage. Co-treatment with z-VAD-fmk inhibited apoptosis and PARP cleavage by EGb 761. CONCLUSIONS: EGb 761 induces the apoptosis of SCC 1483 cells and the caspase cascade is involved in this apoptosis. Therefore, EGb 761 may be used as a chemopreventive agent in oral cavity cancer. Further studies are required on the clinical use of EGb 761.
Antibodies ; Apoptosis* ; Blotting, Western ; Caspases ; Cell Line ; DNA Fragmentation ; Flow Cytometry ; Ginkgo biloba* ; Humans ; Mouth Neoplasms ; Mouth*

Background: The effects of far-infrared radiation (FIR) on the treatment of rotator cuff diseases remains unknown. We evaluated the safety and efficacy of FIR after arthroscopic rotator cuff repair with regard to postoperative pain and healing. Methods: This prospective randomized comparative study included 38 patients who underwent arthroscopic rotator cuff repair due to a medium-sized tear. Patients were randomly divided into the FIR or control group (n = 19 per group). In the FIR group, FIR with an FIR radiator started 1 week postoperatively for 30 minutes per session twice daily. It lasted until abduction brace weaning at 5 weeks postoperatively. We assessed pain using a pain visual analogue scale (pVAS) and measured the range of motion (ROM) of the shoulder at 5 weeks, and 3 and 6 months, postoperatively. The anatomical outcome was evaluated using magnetic resonance imaging at 6 months postoperatively. Results: At 5 weeks postoperatively, the average pVAS score was lower in the FIR group than in the control group (1.5 ± 0.8 vs. 2.7 ± 1.7; P = 0.019). At 3 months postoperatively, the average forward flexion was higher in the FIR group (151.6° ± 15.3° vs. 132.9° ± 27.8°;P = 0.045), but there was no significant difference at 6 months postoperatively. There was no significant difference in healing failure between the groups (P = 0.999). Conclusions FIR after arthroscopic rotator cuff repair could be an effective and safe procedure to reduce postoperative pain, thereby facilitating rehabilitation and better ROM in the early postoperative period.

PURPOSE: Emergency medical service (EMS) providers often care for pregnant women at risk for out-of-hospital delivery and born-before-arrival neonates. As the increase in mortality and morbidity from out-of-hospital delivery is well established, this study sought to determine whether a delivery and neonatal care education program could impact the knowledge and practice of EMS providers. METHODS: EMS providers working in the southeast Gyeonggi province in South Korea received an education program for out-of-hospital delivery and neonatal care. The program consisted of a pretest, didactic, mannequin training, and posttest. Six months after the education program a follow-up survey was administered. A paired t-test was then used to compare pretest and posttest scores. Overall, 56 EMS providers completed the study. RESULTS: The pretest average score was 80.4 and the posttest average score was 92.9 (p<0.001). The percentage of correct answers on each question was relatively and equally elevated in the posttest, regardless of the participant's certification. Participants expressed their satisfaction with the education program and this appraisal was maintained in the 6-month follow-up survey. CONCLUSION: These results suggest that EMS providers can benefit from a didactic and training session regarding out-of-hospital delivery and neonatal care. Further studies are needed, however, to develop the reliability and validity of the test and to determine its clinical applications.
Certification ; Delivery, Obstetric ; Education* ; Emergencies* ; Emergency Medical Services* ; Female ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Infant, Newborn ; Manikins ; Mortality ; Pregnant Women ; Reproducibility of Results ; Republic of Korea

PURPOSE: To evaluate the result of the treatment with external fixator and early ROM exercise to prevent the stiffness and contracture of the elbow in unstable elbow injury. MATERIALS AND METHODS: From Jan. 1997 to Dec. 2001, ten patients of unstable elbow injury treated with hinged external fixator and early ROM exercise were evaluated. The age was average 37 years. The patients were followed at least 1 years and motorcycle injury (4 cases) was most common. Nine cases were comminuted fractures and one case was fractures with dislocation. We estimated the result of the treatment with Mayo elbow performance index. RESULTS: ROM exercise started in average 2 days after operation. Two cases were treated by ilizarov and eight cases treated by elbow distracter modified by the author. The result of the treatment was estimated as following: excellent in two, good in three cases, fair in eight cases, and poor in two case. CONCLUSION: There were satisfactory results in patients treated with external fixation with early ROM exercise, whose injuries had difficulty in being fixed internally. The authors recommend hinged external fixation and early ROM exercise to prevent postoperative stiffness & contracture of elbow joint in this circumference.
Contracture ; Dislocations ; Elbow Joint ; Elbow* ; External Fixators* ; Fractures, Comminuted ; Humans ; Motorcycles

There has been a significant decline of infectious disease in childhood due to an improvement of economy, living standard and medicine. But accidents in childhood is rather increased and encountered in major cause of death. The child is not so fully developed mentally and physically, that he is vulnerable to accident. Most accidents have been rocognized as being preventable with a few attention of parents or neighours. Therefore, parental health education should be emphasized as one of the important preventive measures against accidents. The authors reviewed the records on 1,648 accidental pediatric patients in the emergency room of CNUH during 6 years period from Jan. 1976. To Dec. 1981. The results were as follow: 1. The frequency of pediatric accidental patient in emergency room was gradually increased year by year and the monthly distribytion revealed a slightly higher in summer season from May to August. 2. According to the patient's residency, the urban to rural ratio was 1.6:1 and the male to female ratio was 1.9:1. 3. The most common physical accident was traffic accident(25.3%), the second being fall down accident(17.3%), then in decreasing order foreign body aspiration or inoculation(14.8%), burn(13.6%), laceration(12.6%), and bite(5.1%), The most common injury site of body by physical accident was head(56.5%) and next in decreasing order trunk & abdomen(18.1%), left leg(15.3%), right leg(13.9%), left arm(12.4%) and right arm(10.5%). 4. The frequency of chemical accident in decreasing order as follow ; CO poisoning(31.5%), rodenticidal drug poisoning(11.7%), insecticidal drug poisoning(9.1%), organic phosphorus poisoning(9.1%) and DDS poisoning(4.2%). 5. Majority of cases were carried to emergency room within 6 hours after accident. 6. The prevalent age for physical accident were between 3-6 years(28.6%) and 6-12 years(28.7%). 7. The prevalent age for chemical accident were between 1-3 years(30.5%). Comparing period of 1979-1981 with period of 1976-1978, the results were concluded as follow ; 1.Frequency of accidents was remarkably increased with predominant male and urban children. 2. Frequency of traffic accident, bite, head trauma, rodenticidal, insecticidal and organic phosphorus poisoning were decreased while those of fall down, foreign body aspiration, burn, laceration, and CO poisoning rather increased. 3. Patients were carried to hospital more rapidly in cases of physical accidents. 4. Age prevalent for physical accidents was to by younger while for chemical accidents being older. 5. Physical accidents were markedly increased, while chemical accidents being minimally changed.
Accidents, Traffic ; Burns ; Cause of Death ; Chemical Hazard Release ; Child* ; Communicable Diseases ; Craniocerebral Trauma ; Emergencies ; Emergency Service, Hospital ; Female ; Foreign Bodies ; Health Education ; Humans ; Internship and Residency ; Lacerations ; Male ; Parents ; Phosphorus ; Poisoning ; Seasons ; Socioeconomic Factors

Neurenteric cysts are developmental cysts derived from embryonic endodermal layers. Fewer than 100 have been reported in which there were no associated bone or soft-tissue malformations and only six among those cases showed intramedullary location in the literatures. The authors report a 16-year-old young man with a thoracic intramedullary neurenteric cyst which presented with symptoms of axillary pain and paraparesis. The magnetic resonance imaging showed intramedullary mass extended from level of T3 to T7. There was no associated bone or soft-tissue anomaly. This cyst was partially excised and marupialized into subarachnoid space. The pathological findings were compatible with neurenteric cyst. Nine months later, the cyst recurred and at second operation, cyst wall was removed completely.
Adolescent ; Endoderm ; Humans ; Magnetic Resonance Imaging ; Neural Tube Defects* ; Paraparesis ; Recurrence ; Spine* ; Subarachnoid Space

BACKGROUND: Fatty degeneration of rotator cuff is a well-known predictor of postoperative outcome. The purpose of this study was to evaluate the clinical features of rotator cuff tears involving subscapularis, and investigate whether fatty degeneration quantified from only the upper subscapularis correlates better with clinical outcomes than quantified from the whole subscapularis. METHODS: We retrospectively analyzed 315 consecutive patients who underwent arthroscopic repair for rotator cuff tears involving subscapularis with a minimum follow-up of 1 year. Preoperative and postoperative visual analogue score for pain, range of motion and functional scores were assessed. Integrity of the repaired tendon was assessed at the 1-year follow-up with either magnetic resonance imaging or ultrasonography. RESULTS: The mean Goutallier grade of whole cross-section was significantly lower than that of upper cross-section (1.59 vs. 1.71, p<0.05), but significantly higher than that of lower cross-section (1.59 vs. 1.01, p<0.05). In analysis of 37 re-tears, the occupancy of severe fatty degeneration in upper cross-section was 86.5%, which was significantly higher than that seen in whole cross-section (56.8%, p<0.05). We calculated the cut-off tear size for prediction of re-tears as 19.0 mm for retraction and 11.0 mm for superior-inferior. The cut-off Goutallier grade was 2.5 for both whole and upper cross-sections, but area under the curve was greater in the upper cross-section than the whole (0.911 vs. 0.807). CONCLUSIONS: As fatty degeneration of upper subscapularis demonstrated a more distinct spectrum than whole subscapularis, we suggest that measuring fatty degeneration of upper subscapularis can be a more useful method to predict clinical prognosis.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Methods ; Prognosis ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Statistics as Topic ; Tears ; Tendons ; Ultrasonography

BACKGROUND: In this study, we attempted to generate RBCs from CD34+ cells in cord blood using a 3-step culture protocol and also evaluated a change in immunophenotypic characteristics and expression profile according to erythropoietin (EPO) concentrations and culture duration. METHODS: Using mini-MACS columns, CD34+ cells were isolated from cord blood. The culture procedure comprised three steps. For each step, cells were cultured sequentially for 7 days in a serum free liquid medium with a specific combination of growth factors for 21 days. [1st step: Flt3-ligand (Flt3-L), thrombopoietin and stem cell factor (SCF); 2nd step: IGF-1, SCF and EPO; and 3rd step: IGF-1 and EPO] To evaluate the effect of EPO on proliferation and differentiation, cells were cultured with different EPO concentrations (0, 3, 10 & 20 U/mL). Cell count and morphology were monitored during the culture. For phenotyping, antibodies to CD34, CD38, CD45 and glycophorin A (GPA) were used. The expression profile of cultured cells was analyzed by 17, 000-gene microarray analysis. RESULTS: As EPO concentration increased, cell expansion was also increased, showing a maximum expansion at 20 U/mL. The cell population showed a gradual decrease in expression of CD34 and CD45, whereas the expression of GPA was not prominent in any conditions. However, we observed increased expression in some genes associated with erythropoiesis (e.g. glycophorin A, rhesus blood group CcEe antigens). CONCLUSIONS: This study shows that erythropoietin enhances the proliferation of hematopoietic progenitor cells. Our culture system did not achieve pure production of RBCs, but induced expression changes that indicated erythroid differentiation.
Antibodies ; Cell Count ; Cells, Cultured ; Erythropoiesis ; Erythropoietin ; Fetal Blood* ; Glycophorin ; Hematopoietic Stem Cells ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Microarray Analysis ; Stem Cell Factor ; Thrombopoietin

BACKGROUND/AIMS: It is still unclear whether Super Paramagnetic Iron Oxide-Magnetic Resonance Imaging (SPIO-MRI) is a clinically useful imaging modality for patients with hepatocellular carcinoma (HCC). This study searched for the clinical usefulness and limitations of SPIO-MRI with respect to tumor detection capacity, false positive and negative rate, and early recurrence rate. METHODS: From December 1999 to February 2001, 218 patients who were surgical candidates by 3-phase dynamic helical CT (3dHCT) were enrolled. We reviewed the medical records and radiologic findings, retrospectively, and postulated the post-operative pathologic findings and the early recurrences within 3 months as the standards for the true positive lesion. RESULTS: The mean number of nodules detected by SPIO-MRI was significantly more numerous than that of 3dHCT (p<0.01). Modifications of treatment strategy due to the discordant findings between SPIO-MRI and 3dHCT for tumor resectability were observed in 22 (10.1%) out of 218 patients. Early recurrences were observed in 10 patients (7.8%). The false positive and negative rates of SPIO-MRI were 6.3% and 13.3%, respectively. CONCLUSIONS: We demonstrated that the tumor detection rate of SPIO-MRI was better than that of 3dHCT. Given the relatively acceptable false positive and negative rates, SPIO-MRI could be an appropriate preoperative imaging modality for patients with HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; *Contrast Media ; False Negative Reactions ; False Positive Reactions ; Female ; Ferrosoferric Oxide ; Humans ; Iron/*diagnostic use ; Liver Neoplasms/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Oxides/*diagnostic use ; Tomography, Spiral Computed