Slipped femoral capital epiphysis is the condition in which the femoral head begins to slip gradually off the femoral neck. After first discription of Ambrose Pare(1572), the world literature has presented many cases, usually more than one hundred in each clinic. Its incidence in Korea, however, is extremely rare and particularly it is difficult to find out the report of typical case. The author reports here a typical case of billateral slipped femoral capital epiphysis in a 17 year old boy with symptom duration of 2 years on right side and 6 months on left side. Physical examination showed his body stature to be normal and his genital organs to have no abnormalities. However, both hips revealed severe pain and limited range of motion, especially in internal rotation and abduction, which restricted his normal gait. Operative reduction of epiphysio-cervical distorsion was successful in the left hip. After skeletal traction of the left hip, an anatomical repositioning by intraarticular wedge rection osteotomy was maintained by 3 Knowles pins. 3 months postoperatively he resumed partial weight bearing on his left hip with little pain and improved range of motion. Further restoration of function can reasonably be expected.
Epiphyses ; Femur Neck ; Gait ; Genitalia ; Head ; Hip ; Humans ; Incidence ; Korea ; Male ; Osteotomy ; Physical Examination ; Range of Motion, Articular ; Traction ; Weight-Bearing

PURPOSE: This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. METHODS: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. RESULTS: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(chi-square=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. CONCLUSION: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
Cross-Sectional Studies ; Humans ; Incheon ; Recurrence ; Stroke*

No abstract available.
Genetic Therapy*

Objective: Menstruation is a great part as the procedure for physiological, psychological development and physical growth, and menstrual disorders are very common problems in adolescence period. these problems can be resolved by interview or appropriate education of normal pubertal development. However unlike other developed countries, systematic report or appropriate education for menstruation may not be performed in our country. Therefore. our pediatric department investigated for menstruation of normal pubertal age women as an information educating adolescence. Methods: In cross-sectional study (ex, questionnaire), 4112 junior high and high school girl students (12~18 years old) in Ansan, Kyungki-do were investigated for menarcheal age, menstrual cycle, duration, amount, premenstrual syndrome, dysmenorrhea and relation to family history. Resulta: 1) Mean Menarcheal age was 12.9+/-1.2 years. According to menarcheal age by present age, menarcheal age was younger when present age was young as menarcheal age 11.8+/-0.6 years at 12 years, 13.3+/-1.1 years at 16 years, and 13.7+/-1.1 years at 18 years, respectively (p<0.001). 2) The month during which menarche occurs most frequently was August (14.7%), followed by July, December and January. 3) Considering menstrual cycle, mixed type (regular and irregular cycle) was most common (39.0%), and menstrual cycle became regular after mean 8.8+/-8.4 months. 4) In women having regular menstrual cycle, most women (53.l0%) had menstrual cycles between 26 and 30 days, next was 21~25 days and 31~35 days according to frequency. 5) Menstrual duration was 5~6 days by 49.6% of the women. 6) Premenstrual syndrome was noted in 56.0% of the women, in that 42.5% experienced occasionally and 13.5% always, respectively. 7) Dysmenorrhea was showed in 85.0% of the women. A total of 63.7% of the respondents suffered from dysmenorrhea was unaffected on daily activity as grade l and was needed no medication to relieve pain. Grade 2 (20.5%) was defined that limited daily activity and was needed medication to relieve pain. Grade 3 (0.9%) was defined that inhibited daily activity seriously, and was unimproved by analgesics. 8) The prevalence of dysmenorrhea was 78.0% at 12 years, 85.9% at 15 years and 94.0% at 18 years, respectively. Getting older, frequency of dysmenorrhea was increasing. 9) Dysmenorrhea was experienced for the first time during the first year after the menarche by 65.3% of the women. The amount of menstrual bleeding was significantly correlated to the severity of dysmenorrhea (P<0.001), and dysmenorrhea reported by the women was singificantly correlated to maternal dysmenorrhea (p<0.01) and to sisters with dysmenorrhea (p<0.001). Conclusions: We found that Korean adolescent girls had earlier menarcheal age than past period, and they had many problems for menstruation. This study suggested that it may be needed adolescent education and appropriate treatment of menstrual disorders.
Adolescent ; Analgesics ; Cross-Sectional Studies ; Surveys and Questionnaires ; Developed Countries ; Dysmenorrhea ; Education ; Female ; Female* ; Gyeonggi-do* ; Hemorrhage ; Humans ; Menarche ; Menstrual Cycle ; Menstruation* ; Premenstrual Syndrome ; Prevalence ; Siblings

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

No abstract available.
Animals ; Rats* ; Sepsis*

BACKGOUND: Cuff overinflation may cause premature rejection of the laryngeal mask airway (LMA) or provocation of incomplete and ineffective reflex responses. Therefore a previous report recommends that the cuff is inflated to a pressure of 60 cmH2O to minimize side effects. The objective of this study was to assess the possibility of controlled positive pressure ventilation in adults when intra-cuff pressure of LMA was set to 60 cmH2O. METHODS: We studied 20 adult patients who received general inhalational anesthesia with LMA and mechanical positive pressure ventilation for gynecological operations. The following variables was determined during anesthesia at two time points 3 min after endotracheal intubation and 5 min before neuromuscular blockade: pop-off pressure, tidal volume, peak-air way pressure, plateau pressure, compliance, SpO2, and ETCO2. RESULTS: Mean compliances measured were normal. Mean airway pressures (peak, plateau) were 13.6 and 15.1 cmH2O at two time points respectively while setting the tidal volume with 10 ml/kg. However, pop-off pressure were 18.3 and 20.1 cmH2O, respectively. Mean tidal volumes without gas leak around the LMA cuff were 14.5 and 14.5 ml/kg, respectively. Mean SpO2 and mean ETCO2 were measured 99.0 and 99.2%, 31.3 and 30.3 mmHg in two time points, respectively. CONCLUSIONS: The study suggested that controlled mechanical positive pressure ventilation using the laryngeal mask airway with 60 cmH2O intra-cuff pressure were be adequate when pulmonary compliance and airway resistance were normal.
Adult ; Airway Resistance ; Anesthesia ; Compliance ; Humans ; Intubation, Intratracheal ; Laryngeal Masks* ; Neuromuscular Blockade ; Positive-Pressure Respiration ; Reflex ; Tidal Volume ; Ventilation*

PURPOSE: One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. METHODS: We analyzed the medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient`s urine becomes protein free. RESULTS: There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone 60mg/m2 daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased and proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein A1 (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). CONCLUSIONS: This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed.
Apolipoproteins ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias* ; Lipoprotein(a) ; Male ; Medical Records ; Nephrotic Syndrome* ; Prednisolone ; Proteinuria ; Recurrence* ; Serum Albumin ; Steroids ; Triglycerides

OBJECTIVES: Due to the heterogeneous receptor distribution and changes of receptor status over time, the biochemical measurement of estrogen receptor status of biopsy specimens is not sufficient to diagnose breast cancer. As a result, I-123 labeled estradiols have been applied for the diagnosis. The purpose of this study was to develop a suitable radioligand for imaging estrogen receptor-positive human breast tumors. METHODS: Among the various estradiol derivatives, 17alpha-[123I]iodovinyl estradiol ([123I]IVE) has been prepared from 17alpha-ethynyl estradiol. Labeling of E-17alpha-[123I]iodovinyl estradiol (E-[123I]IVE) was carried out using peracetic acid with [123I]NaI and Z-[123I]IVE labelling was archived using chloamine- T/HCl solution with [123I]NaI. Labeling yield was determined by silica thin-layer chromatography (TLC) and radiochemical purity was measured by high performance liquid chromatography (HPLC). The biodistribution of E-[123I]IVE was measured in immature female rats at 60 min, 120 min and 300 min after injection. RESULTS: The labeling yield of two isomers was 92% and 94% (E-[123I]IVE and Z-[123I]IVE, respectively). The radiochemical purity was more than 98% after purification. The highest uptake was observed at 120 min in uterus (3.11% ID/g for E-[123I]IVE). CONCLUSION: These results suggest the possibility of using E-[123I]IVE as an imaging agent for the evaluation of the presence of estrogen receptor in patients with breast cancer.
Animals ; Biopsy ; Breast Neoplasms ; Chromatography, Liquid ; Chromatography, Thin Layer ; Diagnosis ; Estradiol* ; Estrogens ; Female ; Humans ; Peracetic Acid ; Rats ; Silicon Dioxide ; Uterus

BACKGROUND: The angiotensin-converting enzyme inhibitors have been found to be safe and efficacious in the treatment of essential hypertension. Fosinopril is the first angiotensin-converting enzyme inhibitor from a new class of agents containing phosphorus. This drug is known to be metabolized to almost and equal extent by the hepatic and renal pathways. METHODS: This study was performed to investigate the efficacy and safety of oral fosinopril, a new class of phosporus-containing angiotensin converting enzyme inhibitor, on essential hypertension. A single daily dose of 10mg to 20mg fosinopril was administered in 21 hypertensive patients with diastolic blood pressure in the range of 95mmHg-115mmHg while off all other anti-hypertensive agents for 10 weeks. Blood pressure and heart rate were measured every 4 weeks. The complete blood count, blood chemistry by SMA-12, serum electrolytes and urinalysis were performed at 12th week of therapy. RESULTS: 1) Baseline systolic and diastolic blood pressures after 2 weeks of placebo at sitting position were 158.8+/-15.7 and 99.4+/-6.3mmHg respectively. There was a statistcally significant reduction of blood pressure after 4 week treatment of fosinopril which was maintained up to 12 weeks of follow-up(158.8+/-15.7-99.4+/-6.3mmHg vs 139.3+/-18.2/86.6+/-10.3mmHg, p<0.05). 2) The proportion of responders defined by diastolic blood pressures less than 90mmHg or decline more than 10mmHg at 4, 8 and 12 weeks after treatment with fosinopril were 90.5, 95.2, and 95.2% respectively. 3) THere were no significant changes in blood chemistry, serum electrolytes, hematologic findings and heart rate over the treatment period. 4) Three patients experienced severe non-productive cough that required to discontinue the medication. CONCLUSION: In patients with mild to moderate hypertension, once-daily fosinopril(10mg and 20mg) provided significant anti-hypertensive effects without serious side effects. The 10mg dose was effective in majority of patients and may be considered as a starting dose.
Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Electrolytes ; Fosinopril* ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Urinalysis