No abstract available.
Low Back Pain* ; Pregnancy*

No abstract available.
Anemia, Aplastic* ; Discitis* ; Humans ; Low Back Pain*

BACKGROUND: We sought to develop a novel index based on the skeletal muscle mass that reflects the change of quality of life (QOL), and is the most appropriate index for the body composition of the elderly in Korea. Whether lower extremity skeletal muscle mass index (LESMI) is an appropriate novel new index to diagnose patients with sarcopenia was also evaluated. A cut-off value for each index was reported to facilitate the diagnosis of patients with sarcopenia in a Korean population. METHODS: We used the 5th Korean National Health and Nutrition Examination Survey data from 2010. We analyzed 409 elderly patients, including 231 men and 178 women, aged ≥65 years. Patients were diagnosed by calculating their skeletal muscle index based on the skeletal muscle mass measured using dual energy X-ray absorptiometry. Obesity and osteoporosis were used to screen data and EuroQOL-5 dimension as a health questionnaire. RESULTS: The prevalence of sarcopenia in each index was obtained based on its cut-off value for diagnosing sarcopenia. There was a significant difference between the obesity rate of elderly patients diagnosed with sarcopenia and those who were not based on each index. There was no significant difference in the prevalence of osteoporosis between the groups. Sarcopenia diagnosis based on the LESMI was significantly correlated with QOL. CONCLUSIONS: LESMI, a novel index based on skeletal muscle mass, reflects changes in QOL and is appropriate for the body composition of elderly people in Korea.
Absorptiometry, Photon ; Aged ; Body Composition ; Diagnosis ; Female ; Humans ; Korea ; Lower Extremity ; Male ; Muscle, Skeletal ; Nutrition Surveys ; Obesity ; Osteoporosis ; Prevalence ; Quality of Life ; Sarcopenia

OBJECTIVE: We used the radiologic foot mapping system to evaluate the characteristics of hallux valgus. METHOD: We studied the radiographs of 47 feet of 29 patients who had the hallux valgus. The weight bearing foot AP and lateral views of both sides were taken. The hallux valgus angle, first and second, first and fifth, and second and fifth metatarsal angles were measured with conventional methods. In addition we measured metatarsus primus varus (MPV) and proximal first metatarsal inclination (PFMI) angles. On lateral views, we measured calcaneal pitch, talar pitch and arch depth. By mapping system, we marked T1 through T5, MH1 through MH5, MB1 through MB5, CC, TN and NC, respectively. RESULTS: The first and fifth metatarsal angles were significantly larger in the patients with hallux valgus (p<0.05). The metatarsus primus varus angle was significantly larger in the patients with hallux valgus (p<0.05). The X coordinates at T1 and MH1 were significantly larger in the patients with hallux valgus (p<0.05). The Y coordinates of the MB1, NC and TN were significantly larger negative values in the hallux valgus patients (p<0.05). CONCLUSION: In hallux valgus, the first metatarsocuneiform joint is the site of origin of metatarsus primus varus. The lateral splaying was present from the 5th toe to tarsal bones in hallux valgus groups.
Foot* ; Hallux Valgus* ; Hallux* ; Humans ; Joints ; Metatarsal Bones ; Tarsal Bones ; Toes ; Weight-Bearing

Hyponatremia is commonly seen in those patients with central nervous system injury associated with infection or trauma. And decreasing intracranial pressure through restriction of maintenance fluid and salt is practiced as a routine therapeutic measure in the early stages of meningitis to prevent or ameliorate the syndrome of inappropriate secretion of antidiuretic hormone(SIADH). However, lots of patient do not show the typical symptoms of SIADH, instead they are dehydrated, have low plasma volume, increased urine sodium concentration and increased net sodium loss, which are the symptoms of cerebral salt wasting syndrome(CSW). Recent reports have prompted a reconsideration of CSW distinct from SIADH and moreover CSW has more proportion of hyponatremia associated with acute brain insult. CSW involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. While fluid restriction is the treatment of choice in SIADH, the treatment of CSW consists of vigorous sodium and volume replacement. And by correcting hyponatremic state as soon as possible, we can reduce mortality rate and improve neurologic sequelae. We report a case of CSW which was treated by replacement of vigorous sodium and volume replacement.
Brain ; Central Nervous System ; Child* ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Intracranial Pressure ; Meningitis* ; Mortality ; Plasma Volume ; Sodium ; Wasting Syndrome*

Unilateral absence of pulmonary artery is a rare congenital anomaly that is frequently associated with other cardiovascular abnormalities. Most patients who have no associated cardiac anomalies have only minor or absent symptoms in childhood and survive into adulthood. We experienced a case of unilateral absence of pulmonary artery in a 5 year-old female patient with the chief complaint of abnormal chest X-ray finding. Unilateral absence of pulmonary artery was diagnosed by lung perfusion scan, cardiac catheterization with pulmonary and aortic angiography. So we report this case with brief review of related literatures.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Cardiovascular Abnormalities ; Child, Preschool ; Female ; Humans ; Lung ; Perfusion ; Pulmonary Artery* ; Thorax

PURPOSE: Although it is important to know the etiologies of childhood seizures according to age, clinical studies on this topic have been few. The present study was therefore designed to investigate the causes of acute childhood seizures. We hope this study will be helpful in the diagnosis and management of children with seizures. METHODS: This study was retrospectively undertaken to evaluate the age and sex distribution, the clinical seizure types, the seizure causes, and especially the frequencies of age-related seizure causes of 922 cases under 18 years of age, who visited Emergency Departments due to seizures from December, 1999 to January, 2004. RESULTS: The male to female ratio was 1.5 : 1 and the age range was from 1 day to 16 years, 2 months. There were 683 cases(74.1%) with generalized seizures, 61(6.6%) with partial seizures, and 178(19.3%) with unknown clinical seizure types. The causes of seizures were listed as follows : febrile convulsions in 545 cases(59.1%); epilepsies in 229(24.8%); benign convulsions with mild gastroenteritis in 19(1.6%); acute central nervous system infections in 15(1.6%); and metabolic derangements in six(0.7%). Finally, the frequencies of age-related seizure causes were analyzed. Out of 751 cases between 6 months and 5 years of age, 532 cases(70.8%) were febrile convulsions, 122(16.2%) epilepsies, 19(2.5%) benign convulsions with mild gastroenteritis, and 11(1.5%) acute CNS infections. Out of 145 cases among those over 5 years of age, 104 cases(71.7%) were epilepsies, 10(6.9%) febrile convulsions, and three(2.1%) acute CNS infections. CONCLUSION: The above results reveal that the causes of acute childhood seizures in the different age groups are different, and also suggest that febrile convulsion is the most common seizure cause between 6 months and 5 years of age, and epilepsy in more than 5 years of age. We hope that further clinical and epidermiologic studies on this topic will be performed.
Age Distribution ; Central Nervous System Infections ; Child* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Epilepsy ; Female ; Gastroenteritis ; Hope ; Humans ; Male ; Retrospective Studies ; Seizures* ; Seizures, Febrile ; Sex Distribution

PURPOSE: 'Benign convulsions with mild gastroenteritis(BCwMG)' is afebrile seizures associated with gastroenteritis without dehydration or electrolyte imbalance in young children aged almost 6 months to 3 years. Because seizures can occur repeatedly, patients can be misdiagnosed with epilepsy. Therefore, understanding the characteristics of this disease is thought to be important. This study was carried out to investigate the clinical features of the disease. METHODS: From January, 2000 to December, 2003, 17 patients with BCwMG visited the Emergency Department, Inje University Ilsan Paik Hospital. We reviewed the clinical features of seizures, age and sex distribution, laboratory findings and follow-up results. RESULTS: Out of 17 patients with BCwMG, 13 were boys and five girls. Of 17 patients, 14(82.4%) patients were between 1 and 2 years of age. Generalized seizure was observed in all 17 patients. The duration of seizure was between 10 seconds and 10 minutes. Mean seizure frequency was 1.9 times(range, 1-5 times). Two or more seizures occurred in 10 patients(58.8%). All patients had seizures after the onset of gastroenteritis. All episodes occurred within the first five days of gastroenteritis. Rotavirus antigen was positive in stools in eight out of 12 patients(66.7%). Thirteen patients displayed normal psychomotor development at the last follow-up. No patient exhibited a the recurrence of seizures, except for one patient who had a febrile convulsion. CONCLUSION: Our results exhibited that BCwMG is characterized by seizures that are mostly brief and generalized and a cluster of episodes in those aged 1 to 2 years. Seizures occurred within the first three days of gastroenteritis. The proportion of positive rotavirus antigen was more than half.
Child ; Dehydration ; Emergency Service, Hospital ; Epilepsy ; Female ; Follow-Up Studies ; Gastroenteritis* ; Humans ; Recurrence ; Rotavirus ; Seizures* ; Seizures, Febrile ; Sex Distribution

PURPOSE: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. METHODS: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. RESULTS: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). CONCLUSION: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.
Ambulatory Care Facilities ; Breast Feeding ; Caregivers ; Constipation* ; Defecation ; Diet ; Female ; Fissure in Ano ; Gastrointestinal Hemorrhage ; Humans ; Infant ; Male ; Medical Records ; Milk ; Milk, Human ; Pediatrics ; Surveys and Questionnaires ; Skin ; Telephone ; Weaning

PURPOSE: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children. METHODS: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed. RESULTS: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together. CONCLUSION: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.
Anti-Bacterial Agents ; Appendicitis* ; Child* ; Diagnosis ; Follow-Up Studies* ; Humans ; Sensitivity and Specificity ; Ultrasonography