No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans

No abstract available.
Brain Neoplasms* ; Brain* ; Child* ; Humans

BACKGROUND: Bone age measurements have clinical significance in estimation of growth status and prediction of final adult height. Mostly used methods of bone age measurements are Tanner Whitehouse method(TW2) and Greulich-Pyle method(OP). TW2 is known to be more accurate method in determining the bone age, compared to GP. But GP is being used more widely despite some shortcomings, because TW2 is time consuming and need special training. In this study, we observed the correlation between GP and TW2 to evaluate which bone age among three portions of hand and wrist[metacarpals and phalanges(GP1), carpal bones(GP2), distai radius and ulna (GP3)], measured by GP, was more correlated with the bone age, measured by TW2. METHODS: Left hand/wrist radiographs were taken from 100 prepubertal children with normal growth. These radiogrphs were reviewed by two pediatric endocrinologists independently. Bone ages using TW2 were measured at first, and then GP1, GP2, and GP3 were measured. These bone ages had been compared with TW2, using SAS computer program. RESULTS: The mean chronological age of 100 children was 10.0+/-2.5 years(5 years to 14.7 years range, 63 males and 37 females). The bone age by TW2 was 9.0+/- 2.6 years(2.3 to 13.6 years). The bone age by GP1, GP2, and GP3 were 8.8+/-2.5 years, 8.7+/-2.9 years, and 8.3+/-2.8 years, respectively. Bone ages by TW2 were significantly closer to the chronological age than those by GP. The Pea~rson correlation coefficients of GP1, GP2, and GP3 in eomparison to TW2 were 0,87(p=0.0001), 0.94(p=0.0001), and 0.91(p=0.0001), respectively, There are significant correlatkm between bone ages by TW2 and GP. Bone ages by GP2 and GP3 were statistically significantly different from those by TW2(P<0.01). Bone ages by GP1 has no statistical difference with that by TW2(P=0.64). CONCLUSION: TW2 method is more accurate than GP method in determining the bone age, but it needs time-consuming and laborious efforts. We suggest that the use of GP method for the metacarpals and phalanges can result in a considerable saving of time with no significant loss of accuracy and reproducibility.
Adult ; Age Determination by Skeleton ; Child ; Hand ; Humans ; Male ; Metacarpal Bones ; Radius ; Ulna

PURPOSE:Obesity is associated with complications such as unfavorable lipid profiles, hyperinsulinemia, and hypertension. We investigated the degree of obesity, especially defined as BMI and the percentage of overweight for the standard weight (%Wt) on plasma lipid levels and insulin resistance in the pediatric age group. METHODS:In this cross sectional study, 64 children and adolescents were included. Anthropometric data including body weight, height, BMI, %Wt, fat percentage of body weight (Fat%), and waist to hip ratio (WHR) were collected. For metabolic data, 14 hour fasting serum glucose, insulin and lipid profiles were measured and index for insulin resistance (HOMA-IR, FGIR) were calculated. We analyzed if there exist relationship between each anthropometric data and metabolic data. Gender differences were also assessed. RESULTS:Hyperinsulinemia showed high prevalence in obese children (total=21.9%, male=22.5%, female= 20.8%). HOMA-IR correlated with BMI and %Wt (BMI:r=0.308, P<0.05; %Wt:r=0.414, P<0.05). FGIR also correlated with BMI and %Wt (BMI:r=-0.406, P<0.05; %Wt:r=-0.437, P<0.05). Fasting serum triglyceride levels showed statistically significant correlation with BMI and %Wt [Boys (BMI:r=0.334, P<0.05; %Wt: r=0.487, P<0.05), Girls (BMI:r=0.482, P<0.05; %Wt:0.406, P<0.05)]. CONCLUSION: BMI and %Wt were valuable for predicting insulin resistance and triglyceride level. Sexual dimorphism related to insulin resistance and dyslipidemia in obese children was not certain in this study.
Adolescent ; Blood Glucose ; Body Weight ; Child* ; Dyslipidemias ; Fasting ; Female ; Humans ; Hyperinsulinism ; Hypertension ; Insulin Resistance* ; Insulin* ; Obesity ; Overweight ; Plasma ; Prevalence ; Triglycerides ; Waist-Hip Ratio

No abstract available.
Child* ; Humans ; Status Epilepticus*

BACKGROUND: Palmar and axillary hyperhidrosis causes important consequences to the social and professional life of the affected patient. Endoscopic thoracic sympathectomy is considered the treatment of choice, because it causes minimal morbidity and high initial success rates. Therefore we used a single-site access technique for primary hyperhidrosis patients. METHOD: The operation was done under general anesthesia with the patient in a half-sitting position. Through an incision made along the line between lateral 1/3 portion of the clavicle and ipsilateral nipple, a Verres needle was introduced below the second rib. About 1.5L of CO2 was insufflated into the pleural cavity. The needle was changed to a 5 mm trochar through which the electroresectoscope was introduced. The heads of the upper 2nd-4th ribs were identified and the sympathetic chain could be seen through the pleura riding over the ribs close to the costovertebral junction. The 2nd-4th ganglia were coagulated and divided down to the periosteum. Finally the lung was expanded by limiting flow until the airway pressure reach 30~40 cmH2O. The wound was closed after the removal of electroresectoscope. The procedure was then repeated on the opposite side. RESULT: There were no postoperative mortality and major complications requring surgical reintervention. The preoperatively wet and cold hands had became warm and dry immediately after operation. All patients were very satisfied. CONCLUSION: Endoscopic thoracic sympathetic ganglion cauterization is a minimally invasive and highly successful treatment for the patients with primary hyperhidrosis.
Anesthesia, General ; Cautery* ; Clavicle ; Ganglia ; Ganglia, Sympathetic* ; Hand ; Head ; Humans ; Hyperhidrosis* ; Lung ; Mortality ; Needles ; Nipples ; Periosteum ; Pleura ; Pleural Cavity ; Ribs ; Sympathectomy ; Wounds and Injuries

PURPOSE: This study was done to examine the effects of lidocaine patch application to decrease pain and fear during blood sugar testing in elderly patients with DM. METHODS: The participants were 56 elderly patients admitted to J geriatric hospital in G city, Korea. Of the elderly patient, 27 were assigned to the experimental group and 29 to the control group. Participants in the experimental group applied a lidocaine patch on the fingertip for 30 minutes before a blood sugar test. The control group applied a plaster on the fingertip. Pain was evaluated using a visual analogue scale and fear using the Procedure Behaviour Check List. The results were compared using paired t-test and t-test. RESULTS: The scores for pain and fear were significantly lower in the experimental group compared to the control group. CONCLUSION: The lidocaine patch was found to be an effective local anesthetic to relieve pain and fear during blood sugar test in elderly patients with DM without any severe adverse events.
Aged* ; Blood Glucose* ; Humans ; Korea ; Lidocaine*

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation

PURPOSE: This study was conducted in order to examine the effects of death anxiety and meaning of life on somatization of grandparents raising grandchildren. METHODS: A convenience sample of 92 elderly grandparents raising grandchildren was recruited. The study instrument for death anxiety was the 5-point 15 items scale designed by Templer and translated by Ko, Choi, & Lee and for meaning of life, the 7-point 10-items scale by Steger, Frazier, Oishi & Kaler and translated by Won, Kim & Kwon. For somatization, the 5-point 12 items scale designed by Derogatis and translated by Kim, Kim & Won was used. Collected data were analyzed with descriptive statistics, independent t-test, one-way ANOVA, Pearson Correlation and regression using the SPSS 21.0 program. RESULTS: Average scores were 3.55 for death anxiety, 3.43 for meaning of life, and 2.74 for somatization. Death anxiety had the highest positive correlation with somatization. Meaning of life was negatively correlated with death anxiety and somatization. Death anxiety and health status were shown to influence somatization but meaning of life was not shown to influence somatization. CONCLUSION: The research results indicate that death anxiety and health status influence somatization in grandparents raising grandchildren. These results also provide basic information on the importance of nursing interventions in which the variables influencing somatization in grandparents raising grandchildren are considered.
Aged ; Aged, 80 and over ; *Anxiety ; Attitude to Death ; Family ; Female ; Grandparents/*psychology ; Health Status ; Humans ; Income ; Male ; Middle Aged ; *Quality of Life ; Surveys and Questionnaires

Hepatic veno-occlusive disease (VOD) is a rare disease due to occlusion of the terminal hepatic venules and/or sublobular veins, which is a result of endothelial damage from pyrrolizidine alkaloids in herbal teas, irradiation of the liver, or chemotherapy particularly in association with bone marrow transplantation. We recently experienced three cases of VOD developed after radiation therapy. Two cases occurred in hepatocellular carcinoma patients of a 37-year-old man with B viral chronic hepatitis and a 22-year-old man with B viral cirrhosis and the other in a 64-year-old patient with esophageal squamous cell carcinoma. For the treatment of hepatocellular carcinoma, chemoembolization with lipiodol and adriamycin, and external irradiation on the liver mass were done. The total radiation dose was 5400 cGy and 3000 cGy in each case. Five months and 3 months after irradiation, respectively, the resected liver masses showed extensive necrosis due to pre-operative treatment. To treat esophageal carcinoma, pre-operative concurrent chemotherapy of 5-FU and radiation of 4500 cGY were done. One month after irradiation, the radical esophgectomy and wedge biopsy of the liver were done. The liver of all 3 cases showed a dark red appearance with severe congestion in contrast to the pale brown normal liver, which was not included in the radiation field. On micoscopic examination, the terminal hepatic venules and sublobular veins showed subintimal edema, fibrin deposition, and partial or total luminal occlusion by loose fibrous tissue. The centrizonal sinusoids were markedly dilatated and congested with atrophy of hepatocytes.
Adult ; Atrophy ; Teas, Herbal ; Biopsy ; Bone Marrow Transplantation ; Carcinoma, Hepatocellular ; Carcinoma, Squamous Cell ; Doxorubicin ; Drug Therapy ; Edema ; Estrogens, Conjugated (USP) ; Ethiodized Oil ; Fibrin ; Fibrosis ; Fluorouracil ; Hepatic Veno-Occlusive Disease* ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Liver ; Middle Aged ; Necrosis ; Phenobarbital ; Pyrrolizidine Alkaloids ; Rare Diseases ; Veins ; Venules ; Young Adult