PURPOSE: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. METHODS: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. RESULTS: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of 19.19+/-4.58 points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. CONCLUSION: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.
Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Parents ; Child Health ; Surveys and Questionnaires

From July 1989 to February 1993, twelve patients were analysed for infected bone loss which treated with radically debriding all infected dead bone and closed suction-irrigation system with antibiotics and internal lengthening by using the external fixator. The results are summarized as follows. 1, The average time for application of external fixation was 30.7 weeks in tibia, 27 weeks in femur and average time for bone union was 31.5 weeks in femur, 34.2 weeks in tibia. 2. Soft tissue defects were treated with split thickness skin graft in 6 cases, secondary closure in 4 cases, gastrocnemius rotational flap in 2 cases. 3. The length of bone defects after infected bone excision ranged from 2cm to 9.3cm, averaging 4.5cm. The bone defect was treated by internal lengthening after corticotomy with the Ilizarov apparatus in 4 cases, the Orthofix external fixator in 8 cases. 4. Four cases in this series were complicated; one pin tract infection, one angulation deformity, one checkrein deformity, one flexion contracture of knee joint. 5. Infection was managed with radical debriding infected dead bone and closed suction-irrigation system with antibiotics in all cases. 6. We recommend that the infected bone loss can be effectively managed with radically debriding dead bone and closed suction-irrigation system with antibiotics and lengthening with Ilizarov apparatus or Orthofix external fixator.
Anti-Bacterial Agents ; Congenital Abnormalities ; Contracture ; External Fixators ; Femur ; Humans ; Knee Joint ; Skin ; Tibia ; Transplants

Intertrochanteric fractures of femur were increasing in their incidence in morden life. The compression hip screw and Ender nail are popular treatment modalities of the interochanteric fracture of femur. We had tried to clarify the complications of intertrochanteric fracture according to the treatment modality-compression hip screw and Ender nail. We obtained the results as followings with the patients who had intertrochanteric fracture of femur which were managed by compression hip screw (56 cases) and Ender nail (22 cases) through the period of March 1987 to June 1993. The summary of the results; 1. Mechanical complications were developed in 9 patients(16%), 9 complications in the group with compression hip screw and 7 patients(32%), 12 complications in Ender nail. 2. Local complications were developed in 4 patients(7%) in compression hip screw and 10 patients (46%) in Ender nail and the most common local complication was the knee joint pain(7 patients; 32%). 3. Statistically, more significant decrease of neck-shaft angle was shown with group using Ender nail for unstable fracture than stable fracture group and compression hip screw group. 4. The degree of shortening was incrased in group with Ender nail than in group with compression hip screw, but there was no statistical significance. 5. The grade of osteoporosis was not related to the change of neck-shaft angle and shortening and also to the development of mechanical complication. According to the above results, compression hip screw was a more stable fixation device than Ender nail in the unstable intertrochanteric fracutre.
Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Osteoporosis

There have long been a lot of controversies on the treatment of unstable thoracolumbar spine fracture, and the role of decompression is also controversial. Compression of the neural elements by retropulsed bone fragments can be relieved indirectly by the reduction with posterior instrumentation or directly by the exploration of the spinal canal through a posterolateral or anterior approach. There is no universal agreement about the indications for each of these method. Authors analyzed the result of 24 cases of thoracolumbar spine fracture which had been operated by anterior decompression and Kaneda instrumentation from the February 1990 to May 1993 at Inha general hospital. The results were as follows: 1. The most common cause of injury was falling from a height, 20 cases (83.3%). And the 12 cases were in the 4th decade, with an average age of 37.7 years. 2. According to McAfee classification, there were 7 stable(29.2%) and 15 unstable bursting fractures(62.5%). And the most common level of injury was L1(11 cases, 45.8%). 3. Neurologic status was improved one or more grade(Frankel grade) in 21 cases except one case of complete paraplegia. 4. The average correctional angle of kyphotic deformity was 13.1° immediate postoperatively, and the loss of correction(average, 6.7°) was observed during the follow-up period. 5. The segmental instability was found at the level below the fusion in three cases during the follow-up period. 6. There was neither failure of instrument, dislodgement of graft bone nor lateral wedging during the follow-up period.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Hospitals, General ; Methods ; Paraplegia ; Spinal Canal ; Spine ; Transplants

Laryngeal cysts can be classified into saccular (24%) or ductal (75%) cysts. In infants who have undergone intubation, ductal cysts are occasionally seen in the subglottic region. These cysts are caused by irritation and obstruction of mucous gland ducts. A 20-month-old infant admitted to our department due to inspiratory stridor, wheezing, and dyspnea. She was born prematurely and had a past history of endotracheal intubation with ventilator of 9 days because of respiratory distress syndrome. At 31 days of age, she was intubated again for 5 days because of pneumonia. She had admitted our hospital repeatedly at 7, 8, 16, and 17 months because of inspiratory stridor, wheezing, cough and dyspnea and she was diagnosed as asthmatic bronchitis. But symptoms developed again, she readmitted. A lateral X-ray film of the neck and neck spiral CT revealed a 6x5 mm sized homogeneous mass in the posterior wall of the subglottic region causing airway obstruction. A laryngoscopy was performed and showed a 4x5 mm sized cystic mass in the subglottic region. Endoscopic resection was done by Nd : Yag laser. The postoperative course was satisfactory. Histologic examination showed a ductal cyst, lined with ciliated cuboidal epithelium. This subglottic ductal cyst was believed to be a late complication of endotracheal intubation.
Airway Obstruction ; Bronchitis ; Cough ; Dyspnea ; Epithelium ; Humans ; Infant ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Larynx ; Lasers, Solid-State ; Neck ; Pneumonia ; Respiratory Sounds ; Tomography, Spiral Computed ; Ventilators, Mechanical ; X-Ray Film

BACKGROUND: MAGE(melanoma antigen gene) has been named as cancer/testis specific antigens since its expression is only detected in the testis or cancer cells. Because of its relatively specific expression in cancer cells, it has been considered as a marker for the early diagnosis of several cancers, or as an appropriate target for a specific immunotherapy mediated by cytotoxic T lymphocytes. Therefore, there have been many reports concerning the expression of MAGE genes in various types of malignant tumors, although only a few reports in human thyroid neoplasms. The purpose of this study was to determine whether the MAGE-1, -2, -3, -4, -5, and -10 genes expressed in different histological types of thyroid tumors and to elucidate the clinical usefulness of MAGE genes on the diagnosis of thyroid tumors. METHODS: Thirty-eight patients who had undergone thyroidectomy at Kosin Medical Center between January and August, 1999 were included in the study. Of the 38 patients enrolled, 26 exhibited papillary carcinoma, 3 papillary carcinoma with lymph node metastasis, 1 follicular carcinoma, 1 medullary carcinoma, 5 nodular hyperplasia, 1 adenomatous goiter, and 1 follicular carcinoma. In the twelve normal control thyroid tissues, total cellular mRNA was extracted from 31 cancer tissues and 7 benign tissues, RT-PCR was run in 35 cycles, with specific primers of the subtypes of MAGE genes. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blot hybridization. RESULTS: In the 26 papillary carcinomas, MAGE-1,-2,-3,-4,-5 and -10 genes were expressed in 88.5%, 92.3%, 3.8%, 26.9%, 26.9%, and 0% by RT-PCR respectively. In the three papillary carcinomas with regional lymph node metastasis, MAGE-1, -2 and -5 genes expressed in two of the three, and MAGE-4 in one of the three cases. In the one medullary carcinoma, the MAGE-1,-2,-4, and MAGE-5 genes were expressed, and in the one case of follicular carcinoma, only the MAGE-2 gene was expressed. In contrast, none of the 7 benign tumors and 12 normal control tissues expressed any of these MAGE genes. The sensitivity of MAGE-1,-2,-3,-4,-5 and -10 genes in thyroid tumors was 83.8%, 90.3%, 3%, 29.0%, 32.3%, and 0%, respectively and the specificity was 100%. CONCLUSION: These results demonstrate that MAGE genes were expressed in the malignant thyroid tumors but not in the benign tumors and normal tissues. Among the MAGE gene families, MAGE-1 and -2 genes were more sensitive than MAGE-3, 4,-5 and -10 genes. However, in order to demonstrate if the MAGE genes could be used for the diagnosis of follicular carcinoma and distant metastasis in thyroid tumors, further study is required.
Blotting, Southern ; Carcinoma, Medullary ; Carcinoma, Papillary ; Diagnosis ; Early Diagnosis ; Goiter ; Humans ; Hyperplasia ; Immunotherapy ; Lymph Nodes ; Neoplasm Metastasis ; RNA, Messenger ; Sensitivity and Specificity ; Sequence Analysis, DNA ; T-Lymphocytes, Cytotoxic ; Testis ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: We analyzed the relationship between MRI patterns and neurologic outcome and explored the effectiveness of MRI as a tool for predicting the outcome. METHODS: We analyzed 23 full term infants with severe HIE retrospectively who were admitted to our NICU from Sep. 1993 to May 1998. Their MRI findings were classified into 4 patterns : type I : deep gray matter injury; type II : cortical, subcortical white matter injury; type III : localized periventricular white matter injury; and type IV : mixed injury. Neurodevelopmental outcome was assessed at a mean age of 30.7 months and the patients were grouped in two - neurodevelopmentally normal(8 cases) and delayed(15 cases, including 4 deaths). RESULTS: All type I patients(n=3) showed severe neurodevelopmental delay. Of seven type II patients, three developed normally(42.9%) and four showed developmental delay(57.1%). All type III patients(n=4) developed normally(P=0.008). Of nine type IV patients, one(11.1%) developed normally and eight(88.9%) showed severe developmental delay. There were twelve patients with lesions including thalamus and basal ganglia injury in MRI(type I+IV) and most of them(n=11, 91.7%) were severely developmentally delayed(P=0.002). Acute total asphyxic insult was documented in 9 of the 23 infants, 8 of 9(88.9%) had patterns of lesions including thalamus and basal ganglia injury. The neurologic outcome was poor for all except one of these patients. CONCLUSION: All the patients with periventricular white matter injury in MRI developed normally whereas all except one patient with subcortical gray matter injury showed severe neurodevelopmental delay. The patterns of brain injury shown in the MRIs of term infants with severe HIE provided significant information about the prognosis for the neurodevelopmental outcome of these infants.
Basal Ganglia ; Brain Injuries ; Brain* ; Humans ; Hypoxia-Ischemia, Brain* ; Infant* ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies ; Thalamus

Short stature is common in case of Fanconi anemia (FA) and may result from inherent abnormalities of FA or endocrinopathies, such as a growth hormone deficiency and hypothyroidism. Growth hormone treatment in FA patients with growth hormone deficiency (GHD) has been controversial because FA itself has a risk of malignancy, and there has been a concern about the increased risk of malignancy from growth hormone treatment. We report on an FA boy with GHD who was diagnosed with FA and undertook stem cell transplantation. Because he showed severe growth failure, growth hormone therapy was initiated at 6 years of age, after he was diagnosed with hypopituitarism, including GHD. He expressed significant catch-up growth with no complications beyond the two year follow up period. This case suggests that growth hormone therapy can be considered in patients with GHD caused by FA, with careful monitoring for malignancy.
Fanconi Anemia ; Follow-Up Studies ; Growth Hormone ; Humans ; Hypopituitarism ; Hypothyroidism ; Stem Cell Transplantation

Purpose: The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE. Methods: This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE. Results: Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (p<0.01). A family history of T2DM, fatty liver, and SPISE value below the cutoff point (4.49) were identified as significant risk factors for T2DM in multiple logistic regression analysis after controlling for age, sex, and body mass index standard deviation score (p<0.01). Conclusion Family history of T2DM, fatty liver, and low SPISE (<4.49) are risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among these risk factors, SPISE is a promising marker for predicting adolescent T2DM; careful monitoring of these individuals is needed to prevent progression to T2DM.

OBJECTIVE: To compare the treatment effects of epidural neuroplasty (NP) and transforaminal epidural steroid injection (TFESI) for the radiating pain caused by herniated lumbar disc. METHODS: Thirty-two patients diagnosed with herniated lumbar disc through magnetic resonance imaging or computed tomography were included in this study. Fourteen patients received an epidural NP and eighteen patients had a TFESI. The visual analogue scale (VAS) and functional rating index (FRI) were measured before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment. RESULTS: In the epidural NP group, the mean values of the VAS before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment were 7.00+/-1.52, 4.29+/-1.20, 2.64+/-0.93, 1.43+/-0.51 and those of FRI were 23.57+/-3.84, 16.50+/-3.48, 11.43+/-2.44, 7.00+/-2.15. In the TFESI group, the mean values of the VAS before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment were 7.22+/-2.05, 4.28+/-1.67, 2.56+/-1.04, 1.33+/-0.49 and those of FRI were 22.00+/-6.64, 16.22+/-5.07, 11.56+/-4.18, 8.06+/-1.89. During the follow-up period, the values of VAS and FRI within each group were significantly reduced (p<0.05) after the treatment. But there were no significant differences between the two groups statistically. CONCLUSION: Epidural NP and TFESI are equally effective treatments for the reduction of radiating pain and for improvement of function in patients with a herniated lumbar disc. We recommend that TFESI should be primarily applied to patients who need interventional spine treatment, because it is easier and more cost-effective than epidural NP.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Spine