This report is a clinical analysis and comparative study with previous report of bronchial asthma at National Medical Center on bronchial asthma in children who were admitted to the MP dept. of national Medical Center from January 1987 to December 1990. The results of the study were as follows: 1) The out-break ratio of bronchial asthma is 3.7% of hospitalized children which is no change that about 4% since 1980. 2) The children under 6 years of ge was 62.7% which among under 3 years was 33.1%. The rate of under 3 year children is increased as previous study. 3) The out-break of bronchial asthma was most common in September and October and so peak incidence was noted in fall and duration of hospitalization was most 2 week. 4) Familial allergic history was positive in 54.6% and bronchial asthma was most common. The presence of allergic past history was 52.2%) and atopic dermatitis was most common 5) Eosinophilia was found in 80.8% and elevated IgE was also in 61.6% of bronchial asthma. 6) We could get positive results of IgE RAST and skin test: D. pteronyssinus, D. farinae, Houst dust. 7) The most frequent findigs of the chest radiograph were within normal limits. 8) The clinical improvement rate of bronchial asthma is 52.5%.
Asthma* ; Child* ; Child, Hospitalized ; Dermatitis, Atopic ; Dust ; Eosinophilia ; Hospitalization ; Humans ; Immunoglobulin E ; Incidence ; Radiography, Thoracic ; Skin Tests

Cow milk allergy can be defined as an adverse immunologic reactions to cow milk protein. The term is often mistakenly applied to other causes of milk intolerence, such as lactase deficiency and galactosemia, which must be differenciated and excluded. We have experienced 10 children of cow milk allergy at neonatal onset who had suffered from G-I symtoms, such as diarrhea, irritability, weight loss, vomiting and abdominal distension. One half of this patients had family history of allergic diseas. All patients have positive specific IgE RAST to cow's milk protein, milk elimination test and milk challenge test. Brest milk feeding and soy bean formula feeding and soy bean formula feeding have started after diagnosis and then gastrointestinal symtoms and signs of all patients are improved but other allergic diseases are combined in 5 children.
Child ; Diagnosis ; Diarrhea ; Galactosemias ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Infant* ; Lactase ; Milk ; Milk Hypersensitivity ; Milk Proteins ; Soybeans ; Vomiting ; Weight Loss

This is the clinical statistics concerning the admitted patients observed in the pediatric department of 24 university hospitals and general training hospitals in Korea during the past 3 years from Jan. 1976 to Dec. 1978.All the patients were classified by year and disease according to international classification of disease by W.H.O.(1965 Revision). The results obtained were as follows: 1. Total number of patients during 3 years were 64,864, of which 18,085 were in 1976,22,084 in 1977 and 24,693 in 1978 with about 10% increment every year. 2. Infectious and parasitic disease were the most frequent, 20,737 cases(31.97%) followed by respiratory tract disease,15,917 cases(24.54%) and neonatal disease, 6,388 cases(11.44%) 3. Ten major leading causes of hospitalization were pneumonia(12.7%),diarrheal disease (9.4%), hyperbilirubinemia and postmaturity, upper respiratkory tract infection, immaturity acute bronchitis and bronchiolitis, infectious hepatitis, nephritis,convulsion, and intestinal obstruction in the order of frequency
Bronchiolitis ; Bronchitis ; Classification ; Hepatitis A ; Hospitalization ; Hospitals, University ; Humans ; Hyperbilirubinemia ; Inpatients* ; Intestinal Obstruction ; Korea* ; Parasitic Diseases ; Respiratory System

PURPOSE: The aim of this study was to estimate the degree of difficulty in total mesorectal excisions (TMEs) for rectal cancer by using statistical methods after analysis of factors affecting the resection time and incomplete resection. METHODS: A total of 63 patients who underwent a total mesorectal excision for rectal cancer were evaluated. MRI pelvimetry data {(transverse diameter (TD), obstetric conjugate (OC), interspinous distance (ID), sacrum length (SL), sacrum depth (SD)}, tumor size (TS), T stage, and body mass index (BMI) were prospectively analyzed. A stepwise multiple regression analysis was performed to determine the operating time prediction equation by using these variables, and the differences in the mean operating time hased on gross evaluations of each specimen were analyzed. RESULTS: A stepwise multiple regression with the operating time as a dependent variable led to the following equation: Operation time (min)=35.726-2.162xTD (cm)-2.324 x OC (cm) + 2.671 x SL (cm) + 1.274 x TS (cm), with r2=0.533 and SEE=5.438. The mean operating time according to a gross evaluation of the TME specimen was 20.0 +/- 7.3 min in complete TME cases (n=42) and 27.9 +/- 7.2 min in incomplete TME cases (n=21) (P<0.001). CONCLUSIONS: MRI pelvimetry data (TD, OC, SL) and tumor size were factors affecting the operation time in TMEs for rectal cancer, and the operating time could be predicted by using the equation of the present study. Also, the mean operating time in incomplete TME cases was longer than that in complete TME cases. Thus, the degree of difficulty of an operation for rectal cancer can be predicted by using these factors.
Body Mass Index ; Humans ; Magnetic Resonance Imaging ; Pelvimetry ; Prospective Studies ; Rectal Neoplasms* ; Sacrum

OBJECTIVE: To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. METHODS: Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. RESULTS: Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05). CONCLUSION: These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US.
Carpal Tunnel Syndrome* ; Healthy Volunteers ; Humans ; Neuromuscular Diseases ; Peripheral Nervous System Diseases ; Ulnar Nerve ; Ultrasonography*

To diagnose constipation accurately in self-reported constipated patients is very important not to miss organic disease and prevent therapeutic abuse. To investigate the etiology of functional constipation is also important to determine the therapeutic modality of constipation. In this systemic review, the clinical usefulness of symptom evaluation, diagnostic tests to rule out organic and systemic disease, and functional tests to discriminate underlying pathophysiology in the diagnosis of constipation were discussed. No specific symptoms or tests were available to predict organic versus functional constipation or differentiate slow transit constipation versus evacuation disorder. Therefore, collaborative studies are necessary to determine the pathophysiology of this disorder.
Blood Chemical Analysis ; Colonoscopy ; Constipation/*diagnosis/etiology ; Defecography ; Humans ; Severity of Illness Index ; Thyroid Function Tests

To diagnose constipation accurately in self-reported constipated patients is very important not to miss organic disease and prevent therapeutic abuse. To investigate the etiology of functional constipation is also important to determine the therapeutic modality of constipation. In this systemic review, the clinical usefulness of symptom evaluation, diagnostic tests to rule out organic and systemic disease, and functional tests to discriminate underlying pathophysiology in the diagnosis of constipation were discussed. No specific symptoms or tests were available to predict organic versus functional constipation or differentiate slow transit constipation versus evacuation disorder. Therefore, collaborative studies are necessary to determine the pathophysiology of this disorder.
Blood Chemical Analysis ; Colonoscopy ; Constipation/*diagnosis/etiology ; Defecography ; Humans ; Severity of Illness Index ; Thyroid Function Tests

Acetylcholine provocation test was performed in 54 patients who were admitted to Seoul National University Hospital between August, 1989 and October, 1990 with chest painn and normal or near normal(narrowin of less than 30%) coronary arteries on baseline coronary angiogram. 1) After provocation with intracoronary acetylcholine, 19 patients showed coronary artery constriction of less than 50%, 5 patients showed constriction of 50 to 74%, 21 patients showed constriction of 75 to 99% and 5 patients showed total occlusion. patients with typical symptoms of variant angina showed coronary artery constriction of more than 50% in 81% of cases while those without such symptoms showed constriction of more than 50% in only 28%. 2) We classified the coronary artery constriction over 50% after acetylcholine provocation into focal, diffuse, combined type and total occlusion. 3) Branches of coronary artery on which constriction was provoked by acetylcholine were right coronary, left anterior descending and left circumflex in the decreasing order of frequency. 4) In patients with focal constriction less than 50%, there was neither ECG change nor development of chest pain, and out of 13 patients with focal constriction of more than 75%, 11 patients showed both chest pain and ST segment change and 2 of them showed either chest pain or ST sement change. 5) In 4 patients with diffuse constriction of less than 75%, we could not observe ECG change and chest pain and in 11 patients with diffuse constriction of more than 75%, six showed chest pain and ST segment change, four showed chest pain without ECG change and one showed neither chest pain nor ECG change. 6) In 5 patients with total occlusion, 3 of them showed both chest pain and ST segment change and 2 of them showed only chest pain. 7) Patients with coronary artery constriction of more than 75% showed significant difference in occurrence of chest pain and ST segment change in comparison with patients with coronary artery constriction of less than 75%(p<0.01). It is suggested that dynamic coronary artery constriction of more than 75% after acetylcholine provocation can be considered as positive test regardless of the morphologic feature of the lesion, whether it is diffuse or focal.
Acetylcholine* ; Chest Pain ; Constriction ; Coronary Vessels* ; Electrocardiography ; Humans ; Seoul ; Spasm* ; Thorax

Acetylcholine provocation test was performed in 54 patients who were admitted to Seoul National University Hospital between August, 1989 and October, 1990 with chest painn and normal or near normal(narrowin of less than 30%) coronary arteries on baseline coronary angiogram. 1) After provocation with intracoronary acetylcholine, 19 patients showed coronary artery constriction of less than 50%, 5 patients showed constriction of 50 to 74%, 21 patients showed constriction of 75 to 99% and 5 patients showed total occlusion. patients with typical symptoms of variant angina showed coronary artery constriction of more than 50% in 81% of cases while those without such symptoms showed constriction of more than 50% in only 28%. 2) We classified the coronary artery constriction over 50% after acetylcholine provocation into focal, diffuse, combined type and total occlusion. 3) Branches of coronary artery on which constriction was provoked by acetylcholine were right coronary, left anterior descending and left circumflex in the decreasing order of frequency. 4) In patients with focal constriction less than 50%, there was neither ECG change nor development of chest pain, and out of 13 patients with focal constriction of more than 75%, 11 patients showed both chest pain and ST segment change and 2 of them showed either chest pain or ST sement change. 5) In 4 patients with diffuse constriction of less than 75%, we could not observe ECG change and chest pain and in 11 patients with diffuse constriction of more than 75%, six showed chest pain and ST segment change, four showed chest pain without ECG change and one showed neither chest pain nor ECG change. 6) In 5 patients with total occlusion, 3 of them showed both chest pain and ST segment change and 2 of them showed only chest pain. 7) Patients with coronary artery constriction of more than 75% showed significant difference in occurrence of chest pain and ST segment change in comparison with patients with coronary artery constriction of less than 75%(p<0.01). It is suggested that dynamic coronary artery constriction of more than 75% after acetylcholine provocation can be considered as positive test regardless of the morphologic feature of the lesion, whether it is diffuse or focal.
Acetylcholine* ; Chest Pain ; Constriction ; Coronary Vessels* ; Electrocardiography ; Humans ; Seoul ; Spasm* ; Thorax

PURPOSE: Primary total knee arthroplasty (TKA) can be an alternative method for treating distal femoral fractures in elderly patients with knee osteoarthritis. The purpose of this study was to evaluate the clinical and radiographic results in patients with knee osteoarthritis who underwent TKA with the Medial Pivot prosthesis for distal femoral fractures. MATERIALS AND METHODS: Eight displaced distal femoral fractures in 8 patients were treated with TKA using the Medial Pivot prosthesis and internal fixation. The radiographic and clinical evaluations were performed using simple radiographs and Hospital for Special Surgery (HSS) knee scores during a mean follow-up period of 49 months. RESULTS: All fractures united and the mean time to radiographic union was 15 weeks. The mean range of motion of the knee joint was 114.3degrees and the mean HSS knee score was 85.1 at the final follow-up. CONCLUSIONS: Based on the radiographic and clinical results, TKA with internal fixation can be considered as an option for the treatment of simple distal femoral fractures in elderly patients who have advanced osteoarthritis of the knee with appropriate bone stock.
Aged ; Arthroplasty ; Femoral Fractures ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteoarthritis, Knee ; Prostheses and Implants ; Range of Motion, Articular