Ultrasonography is a very useul diagnostic modality for the evaluation of clinically suspicious abdominalmasses in infants and children, especially in assessing their existence, size,location, origin and internalconsistency. Authors analyzed and present ultrasonographic findings of 92 pathologically and/or clinically provenpediatric abdominal masses that were studied and treated in Chonnam University Hospital during recent 4 years. Theresults were as follows: 1. The most common originating site was kidney(26 cases: 28.3%), followed bygastrointestinal tract (21 cases: 22.8%), genital organ(17 cases: 18.5%), non-renal retroperitoneum (13cases:18.5%), hepatobilary tract (12 cases:13.0%), and anterior abdominal wall (3 cases: 3.3%) in ordre offrequency. 2. The most common mass was hydonephrosis(18 cases: 19.6%). Neuroblastoma(7 cases:7.6%),hepatoblastoma, ovarian teratoma, periappendiceal abscess and abdominal tuberculosis(6 cases: 6.5%, respectively),Wilms tumor(5 cases: 5.4%) were next in order of frequency. 3. The sex distribution is rather similar, that is ,male 42(45.7%) and female 50(54.3%), but characteristically choledochal cyst(2 cases) and genital mass(17 cases)were found only in females. Considering age distribution, 78 cases(84.8%) were found within the range of one to 15years of age. The rest, 14 cases(15.2%), were under the age of one year. 4. With ultrasonography, the diagnosis ofhydronephrosis could be made easily in every case and we could evaluate its severity and level of obstruction withhigh accuracy. 5. All Wilms tumor were large, round or oval, sharply marginated and relatively homogenous solidmasses. 6. All neuroblastomas were irregular shaped, poorly defined, heterogeneous solid masses. Tumorcalcification and extension across the midline were noted in 6 cases(85.7%) and 5 cases(71.4%), respectively. 7.All periappendiceal abscesses had irregular thickened wall and posterior acoustic enhancement: 4 cases (66.7%)among them were mixed echo pattern and 2 cases(33.3%) ehco free. 8. Among the 6 abdominal tuberculoses, 2 wereseen as irregularly defined solid masses, 1 as conglomeration of multiple hypoechoic nodulles and 3 as mixedpatterns. 9. All hepatoblastomas were seen to be poorly marginated solid masses with more echogenicity thanadjacent normal hepatic echo in 5 cases except one. 10. Among the 6 ovarian teraomas, 4 cases were cystic and 2cases solid. Acoutic shadowing was seen in 3 cases. 11. Choledochal cyst (2 cases), hydrops of gallbladder(1cases) and cyst of pancreas head(1 cases) had similar ultrasonic appearance as a large elliptical systic mass,but, it was important in differential diagnosis to ascertain the existence of gallblader and the connectionbetween the cyst and bile duct.
Abdominal Wall ; Abscess ; Acoustics ; Age Distribution ; Bile Ducts ; Child ; Choledochal Cyst ; Diagnosis ; Diagnosis, Differential ; Edema ; Female ; Hepatoblastoma ; Humans ; Infant ; Jeollanam-do ; Male ; Neuroblastoma ; Pancreas ; Sex Distribution ; Shadowing (Histology) ; Teratoma ; Tuberculosis ; Ultrasonics ; Ultrasonography ; Wilms Tumor

The aim of this study was to determine the minimal inhibitory concentration(MIC) of cefi- xime, which is a 3rd generation of cefalosporin, against 6 species of putative periodon- topathogens; Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Prevotella inter- media, Prevotella nigrescens, Tannerella forsythia and Porphyromonas gingivalis. The efficacy of cefixime was examined by comparing it with that of several antibiotics(amoxicillin, Aug- mentin(R) ciprofloxacin, metronidazole, and tetracycline), which were used as the control. The MIC was measured using a microdilution method. The MIC of cefixime against the putative periodotopathogens, as a single use regimen, was relatively lower than that of the other antibiotics. The MIC of cefixime/metronidazole against P. intermedia ChDC KB14, P. nigres- cens ChDC KB50, F. nucleatum ChDC PV-F37, F. nucleatum ChDC F130, and F. nucleatum ChDC F175, as a simultaneous regimen, was lower than that of the other antibiotics. The concentration of cefixime in the crevicular fluid of volunteers who received 250mg every 12 hours for 3 days was 9microgram/ml after 9 hours. In conclusion, cefixime showed good anti- microbial activity in a single treatment or as a combined therapy with amoxicillin, Aug- mentin(R) or metronidazole against 6 periodontopathogens.
Aggregatibacter actinomycetemcomitans ; Amoxicillin ; Anti-Bacterial Agents ; Cefixime* ; Ciprofloxacin ; Forsythia ; Fusobacterium nucleatum ; Metronidazole ; Porphyromonas gingivalis ; Prevotella ; Prevotella nigrescens ; Volunteers

BACKGROUND: Elastic recoil contributes to the residual lumen reduction immediately after PTCA. We evaluated the factors to influence on immediate elastic recoil after the successful PTCA. METHODS: 88 patients(96 lesions) were studied by quantitative angiography. Angiograms were obtained in two identical near orthogonal projection before PTCA and immediately after the last balloon deflation. RESULTS: Immediately after PTCA, minimal luminal diameter increased from 0.7+/-0.6mm to 1.9+/-0.6mm and percent diameter stenosis was reduced from 77+/-20 to 34+/-21%. The calculated mean elastic recoil was 0.5+/-0.7mm in diameter and % elastic recoils were lesser both in calcified(3+/-23 vs 23+/-24%, p=0.04) and thrombotic(9+/-20 vs 23+/-35%, p=0.02) lesions. The elastic recoil increased significantly according to the inflation diameter of balloon(r=0.32, p<0.01. No significant correlation between the immediate elastic recoil and age, sex, risk factors, eccentricity and lesion length was shown. CONCLUSION: The elastic recoil immediately after a successful PTCA was dependent on the existance of calcium and thrombus on the target lesion and on the balloon size at the maximal inflation.
Angiography ; Angioplasty, Balloon, Coronary* ; Calcium ; Constriction, Pathologic ; Inflation, Economic ; Phenobarbital ; Risk Factors ; Thrombosis

A 21-year-old woman found to be hypertensive was referred for hypertension. On examination, blood pressure was 170/110mmHg in the right arm, 160/100mmHg in left arm,and 120/70mmHg in legs. A grade 2/6 systolic ejection murmur was present at the left upper sternal border, and a chest x-ray revealed a rib notching on the inferior margin of 4th rib. Two-dimensional echocardiogram showed the coarctation of aorta beyound the origin of the left subclavian artery. Biplane TEE demonstrated a discrete narrowing of the descending aorta at the site of coarctation. The blood pressure was 169/86mmHg in ascending aorta and 118/84mmHg in descending aorta. Aortogram showed a localized coarcted aortic segment of 7mm in diameter and 5mm long just distal to the left subclavian artery. Balloon coarctation angioplasty was performed with 7F 30x15mm pediatric balloon dilatation catheter. Balloon position was confirmed on fluoroscopy by the hourglass appearance of the balloon inflation and thereafter, the balloon was inflated until the waist of the balloon disappeared. After procedure, a pull back pressure tracing across the coarctation of aorta revealed no pressure gradient between ascending and descending aorta with 141/90mmHg. Aortogram showed an increase in diameter of the coarctation of aorta to 18mm with aneurysmal formation. 3 months later, follow up aortogram showed no significant change in diameter of coarctation of aorts or aneurysmal formation. Nonsurgical balloon coarctation angioplasty appears to be an alternative therapy for the coarctation of aorta in adults.
Adult* ; Aneurysm ; Angioplasty* ; Angioplasty, Balloon ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Catheters ; Dilatation ; Female ; Fluoroscopy ; Follow-Up Studies ; Humans ; Hypertension ; Inflation, Economic ; Leg ; Ribs ; Subclavian Artery ; Systolic Murmurs ; Thorax ; Young Adult

No abstract available.
Endoscopy* ; Esophageal Motility Disorders*

OBJECTIVES: To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. METHODS: We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. RESULTS: 106 of 125 hospitals responding (84.8%) had more than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. CONCLUSION: Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.
Chief Executive Officers, Hospital ; Health Promotion* ; Hospital Administration ; Hospitals, Private ; Hospitals, Public ; Humans ; Korea* ; Logistic Models ; Organizational Innovation ; Postal Service

PURPOSE: To describe the prevalence and severity of postneonatal epilepsy after neonatal seizures in term neonates as well as to evaluate the predictive factors of postneonatal epilepsy. METHODS: Retrospective analysis of 50 children who experienced neonatal seizures. In children with at least 12 months of follow-up data, the univariate and multivariate logistic regression analysis was applied in order to determine the predictive factors of postneonatal epilepsy. Electroencephalography (EEG), neuroimaging studies, and other clinical variables were systematically analyzed. Infants with abnormal EEG recordings in the initial studies underwent a follow-up EEG examination at 1 or 3 months later. RESULTS: Twelve of 50 neonates with neonatal seizures (24%) developed postneonatal epilepsy. Seventy-five percent (9 of 12) of the children with postneonatal epilepsy were eventually seizure-free without AED (antiepileptic drug), and 25% (3 of 12) had seizures at the last follow-up (modified angel classification 2 or 3, mean follow-up period; 52 months). On the univariate logistic regression analysis, abnormal EEG, Magnetic resonance imaging (MRI) findings, combined with encephalopathy and the number of AEDs were correlated with postneonatal epilepsy (P<0.05). On the multivariate analysis, the persistent abnormality on the follow-up EEG was correlated with postneonatal epilepsy (adjusted odds ratio=20.78; P=0.016). CONCLUSION: The number of intractable cases was relatively low, indicating good prognosis in postneonatal epilepsy. Abnormal EEG, MRI findings, combined with encephalopathy, and the number of AEDs were very good predictors of postneonatal epilepsy. The persistent abnormality in the follow-up EEG was more frequently seen in postneonatal epilepsy patients.
Child ; Classification ; Electroencephalography* ; Epilepsy* ; Follow-Up Studies* ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Magnetic Resonance Imaging ; Multivariate Analysis ; Neuroimaging ; Prevalence ; Prognosis ; Retrospective Studies ; Seizures

BACKGROUND: Almost no study has been carried out to explore the cognitive characteristics of the oldest old population in Korea, even though Korean society is becoming very 'old'. The purpose of this study is to the examine basic cognitive functions of Korean elders over 100 years of age. METHODS: Data collection was completed with 87 elders, 12 males and 75 females. Their mean age was 103.2 for males and 102.3 for females. The average year of education for this population was less than 1 year(0.5 year). We evaluated cognitive functions by K-MMSE and the severity of dementia by CDR (Clinical Dementia Rating). RESULTS: Most of them were able to speak fluently(81.6%) and had reasonable vision(67.8%), but 55.2 % of subjects had full comprehension ability. There was no significant difference in results between elders from Seoul and from other country area. We have divided the sample population into 5 groups according to CDR score; 0(7.4%), 0.5(33.3%), 1(25.9%), 2(14.8%), 3(18.5%), to compare with K-MMSE score. There were significant differences in K-MMSE scores between CDR groups. DISCUSSION: About 7% of elders over 100 years of age are still maintaining normal cognitive function. Considering the physical handicaps of the subjects, probable dementia group(30%) can also be regarded as to possess near normal cognitive function. This study is the first study on Korean centenarians and will provide essential data for future studies on the oldest old.
Aged, 80 and over ; Comprehension ; Data Collection ; Dementia ; Education ; Female ; Humans ; Korea ; Male ; Seoul

Toxic epidermal necrolysis (T~EN) is a severe mucocutaneous disease characterized by epidermal necrosis possibly extended to the entire body surface and involving multiple internal organs. Digestive tract may be involved too, but there is few report about gastrointestinal lesion in patient with TEN. Recently we experienced a case of TEN with gastrointestinal bleeding in previously healthy 32-year-old woman. The condition developed three days after the initiation of treatment with NSAID and progressed caudally, involving 60 percent of the skin surfaces. During a period of admission gastrointestinal bleeding was noticed. The gastrofiberscopy showed diffuse superficial mucosal lesion with oozing from swollen friable and erythematous mucosa. The skin lesion was progressed inspite of withdrawal of causative agents. The patient was expired due to combined septic shock 10 days later. We report this case with gastrofiberscopic findings and a brief review of literature.
Adult ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Mucous Membrane ; Necrosis ; Shock, Septic ; Skin ; Stevens-Johnson Syndrome*

BACKGROUND: The clacification of the wall and narrowing of the lumen of the coronary artery is closely related to the process of atherosclerosis and its severity. Thus, the present study of calcified coronary artery lesions by analysis of cineangiography is attempt to define the incidence and factors to affect the coronary artery calcification. METHODS: Our report concerns a consecutive series of 513 patients who underwent coronary angiography between January 1, 1991 and September 30, 1993. We determined the relationship between the coronary artery calcification and sex, age, risk factors, serum calcium, BUN, creatinine, lesional lumen stenosis and severity of coronary artery disease. RESULTS: Among patients with significant coronary artery disease, 22%(62/282 cases) had the coronary artery calcification by cineangiography. Patients with calcification were older(62+/-8 years) than those without calcification(56+/-10 years)(p=0.0001). The distribution of calcified coronary artery was 35 lesions in LAD, 17 in LCX, 16 in RCA and 4 in LM. The calcification rate was 38%(40/104 cases) for patients with multi-vessel disease, compared to 12%(22/178 case) for those with single vessel disease(p=0.0001). Patients with calcification significantly had the long lesion(22.4+/-13.4mm), compared to those without calcification(18.0+/-11.3mm)(=0.012). Coronary artery calcification was correlated with smoking habits. CONCLUSION: Coronary artery calcification was seen in 22 percent and strongly correlated with age, smoking habits, the severity of disease and length of lesion.
Atherosclerosis ; Calcium ; Cineangiography* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Creatinine ; Humans ; Incidence* ; Risk Factors ; Smoke ; Smoking