No abstract available.
Epidermal Cyst

PURPOSE: Although asthma is generally understood as a disease of the the small airways, FEF25-75%, an index representing peripheral small airways, is a appropriately used in the diagnosis of asthma. The objectives of this study are to assess the usefulness of FEF25-75% in children with asthma for clinical application. METHODS: Five hundred sixty two 5- to 15-year-old children with symptoms suggestive of asthma were enrolled. Methacholine bronchial provocation tests were performed and the children were divided into two groups according to their test results. RESULTS: Forced expiratory flow between 25-75 percent of vital capacity (FEF25-75%) was significantly lower in asthma group (P< 0.001). A 25 percent fall of FEF25-75% of percentage predicted value was correlated with PC20FEV1 (provacation concentration of methacholine required to reduce FEV1 by 20 percent) (r=0.601, P< 0.001). The sensitivity of PC25FEF25-75% (provocation concentration of methacholine required to reduce FEF25-75% by 25 percent) was 94.11 percent when PC20FEV1 was a point of reference. Youden's index was 0.64. CONCLUSION: FEF25-75% is an useful and sensitive index that predicts the presence or absence and the degree of bronchial hyperresponsiveness and PC25FEF25-75% should be brought into clinical application in asthmatic children.
Adolescent ; Asthma* ; Bronchial Provocation Tests* ; Child* ; Diagnosis ; Humans ; Methacholine Chloride* ; Vital Capacity

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.
Antitussive Agents ; Asthma ; Bronchitis, Chronic ; Bronchodilator Agents ; Child ; Cough* ; Diagnosis ; Gastroesophageal Reflux ; Humans ; Interview, Psychological ; Male

Cyclosporin A-induced central neurotoxicity has been rarely reported in patients with nephrotic syndrome. We report a pediatric patient who developed acute leukoencephalopathy diagnosed by MRI during CsA therapy for nephrotic syndrome.
Cyclosporine* ; Humans ; Leukoencephalopathies* ; Magnetic Resonance Imaging ; Nephrotic Syndrome*

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

BACKGROUND/AIMS: Because colonoscopy is a painful procedure, analgesics and sedatives may be necessary as premedication. Midazolam reacts quicker, has a more excellent amnesic effect and fewer complications compared to diazepam. The effects of midazolam depend on dose, age, and rapidity of injection. According to several studies, side effects of midazolam were more common in high-dose injections (more than 5 mg) compared to low dose injections (0.03-0.05 rng/kg). Moreover, low dose injections were found to be as effective as high dose injections. However, there was no report about the effect and the side effects of midazolam in Korea. Therefore, we performed this study to determine the effect of low dose midazolam as premedication for colonoscopy. METHODS: We performed colonoscopy in 99 consecutive patients who were randomly selected (midazolam group: 50, placebo group: 49) prospectively from July 1996 to September 1996. Premedication was administered through intravenous injection of midazolam or saline 0.03 mg/kg, combined with intramuscular injections of meperidine 50 mg, and intravenous injections of Buscopan 20 mg in all patients. Blood pressure, puise rate, and O2 saturation by oxymeter were checked before, during, and 30 minutes after colonoscopy. The degree of amnesia, discomfort, cooperation and acceptance of the re-examination were checked.
Amnesia ; Analgesics ; Blood Pressure ; Butylscopolammonium Bromide ; Colonoscopy* ; Diazepam ; Humans ; Hypnotics and Sedatives ; Injections, Intramuscular ; Injections, Intravenous ; Korea ; Meperidine ; Midazolam* ; Premedication ; Prospective Studies

In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.
Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diagnosis ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Life Style ; Metformin ; Quality of Life ; Weight Gain

In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.
Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diagnosis ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Life Style ; Metformin ; Quality of Life ; Weight Gain

Background: Recent diabetes management guidelines recommend that sodium-glucose cotransporter 2 inhibitors (SGLT2is) or glucagon-like peptide 1 receptor agonists (GLP-1RAs) with proven cardiovascular benefits should be prioritized for combination therapy in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD). This study was aimed at evaluating SGLT2i or GLP-1RA usage rates and various related factors in patients with T2DM and established CVD. Methods: We enrolled adults with T2DM aged ≥30 years who were hospitalized due to established CVD from January 2019 to May 2020 at 13 secondary and tertiary hospitals in Korea in this retrospective observational study. Results: Overall, 2,050 patients were eligible for analysis among 2,107 enrolled patients. The mean patient age, diabetes duration, and glycosylated hemoglobin level were 70.0 years, 12.0 years, and 7.5%, respectively. During the mean follow-up duration of 9.7 months, 25.7% of the patients were prescribed SGLT2is after CVD events. However, only 1.8% were prescribed GLP-1RAs. Compared with SGLT2i non-users, SGLT2i users were more frequently male and obese. Furthermore, they had a shorter diabetes duration but showed worse glycemic control and better renal function at the time of the event. GLP-1RA users had a longer duration of diabetes and worse glycemic control at the time of the event than GLP-1RA non-users. Conclusion The SGLT2i or GLP-1RA prescription rates were suboptimal in patients with T2DM and established CVD. Sex, body mass index, diabetes duration, glycemic control, and renal function were associated with the use of these agents.

Sclerotic fibroma of the skin is an uncommon benign tumor characterized histopathologically by a well-circumscribed dermal nodule showing hypocellular hyalinized collagen bundles. The bundles are separated by clefts and arranged in a storiform pattern. The histogenesis of this fibroma is uncertain. Herein, we report a case of sclerotic fibroma presenting on the left ala nasi of a 27-year-old woman without Cowden's disease.
Adult ; Collagen ; Female ; Fibroma ; Humans ; Hyalin ; Skin