We studied 600 normal lower extremities of Korean students of elementary school in order to establish normal values for the rotational profile and to define any differences between ethnic groups. Rotational profile examined at this study included medial and lateral rotation of the hip and thighfoot angle. The mean value of medial rotation of the hip was 48 degrees with a range of 35 to 64 degrees in male subjects, and 50 degrees with a range of 35 to 60 degrees in female subjects. The mean value of lateral rotation of the hip was 57 degrees with a range of 43 to 75 degrees, and 53 degrees with a range of 40 to 72 degrees in female subjects. Unlike medial rotation, lateral rotation of the hip was greater in male than in female subjects by a mean difference of 4 degrees(T-test, p<0.05). The mean value of thigh-foot angle was 10 degrees with a range of -2 to 23 degrees in male subjects, and 12 degrees with a range of 0 to 21 degrees in female subjects. The total range of hip rotation was slightly greater in Korean than in Caucasians or in Chinese, but, to conclude this, more large study by the same methods will be needed in other areas of Korea.
Asian Continental Ancestry Group ; Ethnic Groups ; Female ; Hip ; Humans ; Korea ; Lower Extremity* ; Male ; Reference Values

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

PURPOSE: Bone involvement is known to develop in 40-70Yo of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement. METHODS: Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups. RESULTS: Twenty-seven patients were enrolled in this study with 14 patients(52Yo) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemo-therapy, but, one AML patient died due to induction failure. CONCLUSION: Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis. (J Korean Pediatr Soc 2000;43:806-813)
Bone Diseases, Metabolic ; Fractures, Spontaneous ; Humans ; Leukemia* ; Lower Extremity ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Radioactivity

This study was performed to evaluate whether increasing hemoglobin before ascent by prophylactic erythropoietin injections prevents acute mountain sickness (AMS). This open-label, randomized, controlled trial involved 39 healthy volunteers with hemoglobin < or =15.5 g/dL who were divided randomly into erythropoietin (n=20) and control (n=19) groups. Epoetin alpha 10,000 IU injections were given weekly for four consecutive weeks. On day 1, and 7 days after the last injection (day 29), oxygen saturation (SaO2), and hemoglobin were measured. The subjects departed Seoul on day 30 and arrived at Annapurna base camp (ABC, 4,130 m) on day 34. AMS was diagnosed when headache and Lake Louise score (LLS) of > or =3 were present. Immediate descent criteria followed US Army recommendations. Two groups differ in hemoglobin levels on day 29 (15.4+/-1.1 vs 14.2+/-1.0 g/dL, P=0.001). At ABC, erythropoietin group had a significantly lower mean LLS, AMS incidence, and number of subjects who met immediate descent criteria. Multiple logistic regression analysis showed that SaO2<87% and control group, but not hemoglobin<15.0 g/dL, independently predicted satisfaction of immediate descent criteria. Erythropoietin-related adverse effects were not observed. In conclusion, erythropoietin may be an effective prophylaxis for AMS.(Clinical Trial Registry Number; NCT 01665781).
Acute Disease ; Adult ; Altitude Sickness/diagnosis/epidemiology/*prevention & control ; Blood Pressure/physiology ; Drug Administration Schedule ; Erythropoietin/*therapeutic use ; Female ; Headache/physiopathology ; Hemoglobins/analysis ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Oxygen/blood ; Questionnaires ; Recombinant Proteins/therapeutic use

PURPOSE: This study was done to survey health behaviors in people at risk for a Cerebrovascular Accident(CVA). METHOD: From November 21 to December 29, 2005, a questionnaire survey was conducted with 171 people at risk for a Cerebrovascular Accident(LDL of above 130 mg/dl & homocysteine of above 15.0 micromol/L). Their physical composition was measured and blood was collected. RESULTS: 1. Of the subjects, 34.5% were smokers, 61.4% were drinkers, 56.7% did not exercise regularly, 57.3% did not control their weight, 26.9% preferred eating meat, and 32.2% preferred salty food. 2. The gender was different between smoking status(Chi2=10.734, p= .001), and drinking status(Chi2=7.185, p= .007), and the age was different between smoking status(Chi2=6.656, p= .010), and drinking status(Chi2=10.722, p= .001). The HbA1C level was different for regular exercise(Chi2= 4.824, p=.028) and the HDL-cholesterol was different for meat-eating preference(Chi2=7.928, p= .005). The observance of troubling signs was different for a salty food preference(Chi2=4.313, p= .038). CONCLUSION: It is necessary to develop programs for taking care of people at risk for a Cerebrovascular Accident and test the effects of the programs in order to reduce the risk factors of CVA and enhance health behavior promotion.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Body Weight ; Chi-Square Distribution ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Exercise ; Female ; *Health Behavior ; Humans ; Male ; Middle Aged ; Nutritional Status ; Questionnaires ; Risk Factors ; Smoking ; Stroke/*epidemiology/etiology

Heparin-induced thrombocytopenia (HIT) is usually caused by anti-platelet factor 4 (PF4)/heparin antibodies, leading to intravascular platelet activation. Circulating anti-PF4/heaprin antibody (IgG, IgA and IgM) was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France) in a 61-yearold man with coronary artery disease and dyspnea on exercise. He had undergone a coronoary angiography using 2,000 unit of heparin before a procedure. On admission, laboratory testing revealed a platelet count of 296x10(9)/L and aPTT (activated partial thromboplastin time) of 38.1 sec. The fall in the platelet count was progressive, resulting in 42% and 53% of platelet counts on the 6th and 12th days after intravenous heparin administration, respectively. He was discharged after coronary artery bypass graft. On discharge, platelet count was normalized to be 212x10(9)/L. On the 7th day after dischage, anti-PF4/heaprin antibody was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France).
Angiography ; Antibodies ; Coronary Artery Bypass ; Coronary Artery Disease ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Heparin* ; Immunoglobulin A ; Platelet Activation ; Platelet Count ; Thrombocytopenia* ; Thromboplastin ; Transplants

For producing large numbers of professional nurses who could manage 21th century's human health, it is necessary to review the direction of registered nursed' national examination which evaluates the nursing education and is granted a licence. For adapting to social expectation of the nurse, we have to nurture the nurses' problem solving capability in clinical setting. Seven divisions of Korean Academy of Nursing suggested clinical competency according to their categories. This paper was presented in the workshop for setting up direction of registered nurses' national examination. We expect that this paper would be more refine and confirm through reviewing subdivisions' learning objectives and discussing clinical minimum level of competence contents with clinical leaders.
Education ; Education, Nursing ; Financing, Organized ; Humans ; Learning ; Mental Competency ; Nursing* ; Problem Solving ; Women's Health*

In most cases, extubation may be safely performed in the operating rooms. However, some cases need leaving the endotracheal tube in place until the patient's condition is appropriate, usually in the Postaneshesia Care Unit (PACU) or Intensive Care Unit (ICU). We retrospectively reviewed the recovery room record of 4,241 patients who performed on operation under general anesthesia at Inha Hospital from January 1993 to December 1993, and then examined into details how many factors are influenced to the time of extubation following surgery. The results were as follows; 1) The overaU frequency of delayed extubation (or PACU extubation) was 9.8% (423/4,241). 2) The surgical disciplines which had the highest number and incidence of delayed extubations were the general surgery (172 cases) and dental surgery (25%), respectively. 3) According to sex, the male patients (243) outnumbered the female counterparts (180). 4) According to age, delayed extubation was most common among infants (<1 year of age) (21.4%). 5) According to operation site, delayed extubation occurred most commonly among operations involving upper abdominal regian (36.1%) followed by thoracic region (22.9%). In conclusion, extubation should be performed when the patient is nearly fuUy awake, of acceptable respiratory rate and depth, and when the effects of muscle relaxants have been fully reversed.
Anesthesia, General* ; Female ; Humans ; Incidence ; Infant ; Intensive Care Units ; Male ; Operating Rooms ; Recovery Room ; Respiratory Rate ; Retrospective Studies

The evolution of total joint replacement is not merely of historical interest. We review the historic development of total joint arthroplasty to look at what has been selected and what has not selected in the past. For more than 30 years, total joint arthroplasty has been progressively developed to improve functional outcomes and survivorship. There has been debate regarding the presence of posterior cruciate ligament (cruciate retaining vs. posterior stabilized) and bearing articulation (fixed vs. mobile). Unicompartmental knee arthroplasty is used through minimally invasive surgery with relatively good results. Still, liner wear and limitation in the range of motion were concerns, prompting the development of highly cross-linked polyethylene and hyperflexion design prostheses. Although there have been a number of improvements in the design and concepts behind hip joint arthroplasty for many years, fixation methods and bearing surfaces are still in debate. Future developments in total joint arthroplasty should be focused on improved function, wear reduction, enhanced kinematics, and increased range of motion. We can look forward to further advancements in total joint arthro-plasty in the area of new materials and designs.
Arthroplasty ; Biomechanics ; Hip ; Hip Joint ; Joints ; Knee ; Polyethylene ; Posterior Cruciate Ligament ; Prostheses and Implants ; Range of Motion, Articular ; Survival Rate ; Ursidae

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