PURPOSE: The purpose of this study was to investigate environmental factors contributing to childhood home slip-down injuries. METHODS: Among a total of 2,812 injured children in our Customer Injury Surveillance System (CISS), we performed a prospective study on 262 children with home slip-down injuries who visited the pediatric emergency department of Asan Medical Center between March 2008 and February 2009. We made a frequency analysis on parameters such as activities just before the accident, the presence of any obstacles or lubricant materials, specific home place in the home where the injuries occurred, flooring materials on which the slipdown happened, additional objects hit after slip down, the site and kind of injury, the duration of therapy, and the disposition. RESULTS: Walking was the most common activity just before the injury. Because rooms and bathrooms were most common places in the home for slip down injuries, laminated papers/ vinyl floor coverings and tiles were the most common flooring materials used in the places where the injuries occured. Most commonly, no obstacles caused the children to slip down, but the furniture, stairs, doorsills, wetness, or soapy fluid followed after that. Over half of the children who slipped (58%) also collided with other than the floor itself after the slipdown, most common objects hit were the edges of the furniture, and doorsills, followed by stairways. The head and neck were the most commonly injured sites, and a laceration was the most common kind of injury. Most children needed less than 1 week of therapy, only 4 children (1.53%) admitted. There were no mortalities. CONCLUSION: The environmental factors contributing to slip-down injuries were the bathroom, laminated papers/vinyl floors, the furniture, stairs, doorsills, and wetness or soapy fluid. Especially, the furniture, stairs, and doorsills can be both primary obstacles and secondary collision objects. For the safety of our children, we must consider these factors on housing, when decorating or remodeling our house.
Accidental Falls ; Child ; Emergencies ; Floors and Floorcoverings ; Head ; Housing ; Humans ; Hypogonadism ; Interior Design and Furnishings ; Lacerations ; Mitochondrial Diseases ; Neck ; Ophthalmoplegia ; Pilot Projects ; Prospective Studies ; Walking

BACKGROUND: Recently, many studies have reported that university students have been suffering from stress because of their the uncertainty of their future and employment. Eating habits have often been considered as one of health-related behaviors that may be affected by life stress. The purpose of this study was to examine the association between stress and eating habits in university students. METHODS: A cross-sectional study was designed. The subjects were 282 university students which assessed their eating habits and stresses. The total numbs of students in the study 263. Eating habits were scored using a questionnaire consisting of three categories-regularity, balance, and preference. The stress was assessed by modified Korean version of BEPSI. RESULTS: The stress score was 2.4 and the total score of eating habits was 44.2. The regularity among the domains of eating habits was 14.1, the balance score was 16.1, and the preference was 14.0. In multiple regression after adjustment with confounding variables, stress had a negative relationship with eating habits. CONCLUSION: The relationship between stress and eating habits was statistically significant, especially in regularity and balance. It is important to know not only the health status, but also the factors associated with health such as stresses and eating habits in order to improve the health status of the university students. Further research needs to uncover causality and make a generalization.
Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Eating* ; Employment ; Generalization (Psychology) ; Humans ; Stress, Psychological ; Uncertainty ; Surveys and Questionnaires

We report a boy with acute pancreatitis without abdominal pain accompanied by hepatic hematoma and massive ascites due to unperceived trauma. The case was difficult to diagnose with image study and the level of amylase. Strong suspicion of pancreatic injury based on mechanism of injury and clinical evaluation would be required to avoid a delay in diagnosis.
Abdominal Pain* ; Amylases ; Ascites ; Diagnosis ; Hematoma ; Humans ; Male ; Pancreatitis*

Atretic cephalocele is a degenerative form of encephalocele, which is detected as a cystic mass in the head, primarily in infants. Its presentation and prognosis vary and depend on various factors, including the nature of the tissues within the cyst, other concomitant anomalies, the site of development, and the presence or absence of an embryonic straight sinus. We here report 2 cases of atretic encephalocele, that were transferred to our hospital because round tumors, misdiagnosed as dermoid cysts, were detected in their parietal lobes immediately after birth. On diagnostic and differential MRI, an embryonic straight sinus was detected while histochemical results indicated that the lesions contained cerebral tissues. Despite these structural anomalies, the two patients developed normally neurologically and no other anomalies were detected. We here discuss these two cases and present a review of the relevant literature.
Dermoid Cyst* ; Embryology ; Encephalocele* ; Head ; Humans ; Infant ; Magnetic Resonance Imaging ; Parietal Lobe ; Parturition ; Prognosis

Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.
Abdomen, Acute* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Infant, Newborn* ; Intestinal Obstruction ; Meckel Diverticulum* ; Pathology ; Sepsis

Of the various endocrine tumors affecting the pancreas, insulinomas and gastrinomas are the most common. In order to facilitate surgery, the localization of tumor is important. However, at the first time of presentation, the localization of tumor was often difficult by CT or ultrasonography because the tumor was relatively too small. The introduction of endoscopic ultrasonography has allowed high-resolution imaging of the pancreas that distinguishes structures as small as 2 to 3 mm in diameter. Thus, it has became easier to detect the lesion site of pancreatic endocrine tumor by endoscopic ultrasonography. We report the 5 patients who had pancreatic insulinoma which were detected and localized by endoscopic ultrasonography.
Endosonography* ; Gastrinoma ; Humans ; Insulinoma* ; Pancreas ; Ultrasonography

Of the various endocrine tumors affecting the pancreas, insulinomas and gastrinomas are the most common. In order to facilitate surgery, the localization of tumor is important. However, at the first time of presentation, the localization of tumor was often difficult by CT or ultrasonography because the tumor was relatively too small. The introduction of endoscopic ultrasonography has allowed high-resolution imaging of the pancreas that distinguishes structures as small as 2 to 3 mm in diameter. Thus, it has became easier to detect the lesion site of pancreatic endocrine tumor by endoscopic ultrasonography. We report the 5 patients who had pancreatic insulinoma which were detected and localized by endoscopic ultrasonography.
Endosonography* ; Gastrinoma ; Humans ; Insulinoma* ; Pancreas ; Ultrasonography

OBJECTIVE: Mirtax is a generic mirtazapine widely used since 2003. We conducted an open-label, uncontrolled 6-week study to evaluate the efficacy and safety of Mirtax for major depressive disorder (MDD). METHODS: Ninety three MDD patients with the diagnosis of MDD and 17-item Hamilton Depression Rating Scale (HDRS) score > or =14 were recruited. The HDRS, Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impressions-Severity Scale (CGI-S) were administered at baseline, 1, 2, 4 and 6 weeks. Response (> or =50% decrease in the HDRS or MADRS score), remission (absolute HDRS score < or =7 or MADRS score < or =10) and CGI-I score < or =2 were also calculated. Adverse event (AE) frequency and severity, weight, blood pressure, and pulse rate were checked to assess safety. RESULTS: The starting dosage was 11.5+/-6.4 mg/day, and the maintenance dosage was 23.1+/-9.4 mg/day. During 6 weeks, HDRS, MADRS and CGI-S scores decreased from 25.1+/-5.6 to 11.9+/-8.6 (mean change -13.1+/-8.3, p<0.001), from 30.2+/-6.3 to 13.73+/-10.40 (mean change -16.5+/-9.8, p<0.001), and from 5.0+/-0.8 to 2.5+/-1.3 (mean change -2.5+/-1.3, p<0.001), respectively. The percentages of responders, remitters by HDRS and patients with a CGI-I score < or =2 were 64.6%, 35.4% and 52.7%, respectively. Significant decreases in HDRS, MADRS and CGI-S scores were confirmed at week 1. The total rate of AEs was 32.3%; the most frequently reported AEs were sedation (4.3%) and constipation (4.3%). Weight was increased from 58.8+/-10.6 to 60.3+/-9.3 kg (mean change 0.7+/-1.7 kg, p=0.004). CONCLUSION: This study, as the first clinical trial of generic mirtazapine, demonstrated the efficacy and tolerability of Mirtax for MDD using a single treatment design.
Blood Pressure ; Constipation ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Drugs, Generic ; Heart Rate ; Humans ; Prospective Studies*

PURPOSE: Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. METHODS: A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. RESULTS: Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. CONCLUSION: Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.
Acute Kidney Injury* ; Anoxia ; Asphyxia ; Blood Pressure ; Cerebrovascular Disorders ; Child* ; Creatine Kinase ; Creatinine ; Diagnosis ; Humans ; Hydrogen-Ion Concentration ; Male ; Mortality ; Myocardial Ischemia ; Myoglobin ; Potassium ; Retrospective Studies ; Rhabdomyolysis* ; Seizures ; Uric Acid

PURPOSE: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. METHODS: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. RESULTS: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. CONCLUSION: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.
Barium ; Child ; Deglutition ; Diagnosis ; Endoscopy ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Humans ; Medical Records ; Numismatics ; Pediatrics ; Stomach ; Upper Gastrointestinal Tract