PURPOSE: Non-A, B, C viral hepatitis is the name given to the disease with clinical viral hepatitis, but in which serologic evidence of A, B, C hepatitis has not been found. Little is known about the etiology and clinical features of non-A, B, C viral hepatitis in children. METHODS: A clinical analysis of 45 cases with non-A, B, C viral hepatitis who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 2001 to June 2004 was carried out retrospectively. Patients who were positive for HBsAg, anti-HAV and anti-HCV and had toxic, metabolic, autoimmune, or neonatal hepatitis were excluded in this study. RESULTS: Among 45 cases of non-A, B, C viral hepatitis, the etiology was unknown in 26 (57.8%), CMV (cytomegalovirus) in 14 (31.1%), EBV (Epstein Barr virus) in 2 (4.4%), HSV (herpes simplex virus) in 2 (4.4%) and RV (rubella virus) in 1 (2.2%). Twenty seven out of 45 (60.0%) patients were under 1 year of age. Sixteen (33.3%) patients had no specific clinical symptoms and were diagnosed incidentally. On physical examination, twenty seven out of 45 patients (60.0%) had no abnormal findings. Forty three out of 45 patients (95.6%) showed classic clinical course of acute viral hepatitis, whereas fulminant hepatitis developed in two patients. Mean serum ALT (alanine aminotransferase) level was 488.7+/-771.9 IU/L. Serum ALT level was normalized in 31 out of 45 patients (81.6%) within 6 months and all patients within 18 months. Aplastic anemia was complicated in a case. CONCLUSION: Although most patients with non-A, B, C viral hepatitis showed a good prognosis, a careful follow-up would be necessary because some of them had a clinical course of chronic hepatitis, fulminant hepatitis and severe complication such as aplastic anemia.
Anemia, Aplastic ; Busan ; Child* ; Follow-Up Studies ; Hepatitis A Antibodies ; Hepatitis B Surface Antigens ; Hepatitis* ; Hepatitis, Chronic ; Herpesvirus 4, Human ; Humans ; Pediatrics ; Physical Examination ; Prognosis ; Retrospective Studies

Cerebral gigantism(Sotos syndrome) is a growth disorder that consists of large size at birth, rapid early growth rate with accompanying advanced bone age, acromegalic features, and developmental delay. Clumsiness in the absence of other abnormal neurologic findings is common. The cause is unknown. We report here a case of 238/12-year-old Sotos syndrome with final adult height above 97 percentile, abnormal brain MRI findings(large ventricles, prominent trigone, prominent occipital horn & thining of corpus callosum), clumsiness, and some behavioral problems.
Adult ; Animals ; Brain ; Growth Disorders ; Horns ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Sotos Syndrome

OBJECTIVES: The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. METHODS: Epidemiological survey was performed at home by means of semistructured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. RESULTS: (1) The mean retiring time was 10.28 h (SD1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h ). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. CONCLUSIONS: The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.
Adult ; Aged* ; Busan* ; Female ; Humans ; Korea ; Male ; Prevalence ; Surveys and Questionnaires ; Sleep Wake Disorders* ; Sleep Initiation and Maintenance Disorders

PURPOSE: The purpose of this study is to investigate the effect on intraocular pressure (IOP) of sutureless clear corneal phacoemulsification with foldable posterior intraocular lens implantation. METHODS: We measured the IOP using both a non-contact pneumotonometer and a Goldmann applanation tonometer preoperatively and postoperatively (1, 3, 10, 30, 60 and 90 days). In operation, the incision site was determined depending on the axis of preoperative corneal astigmatism and divided into two groups: Temporal (Group 1) and Superior clear corneal incision (Group 2). It is postulated that if there is more damage to the surrounding tissue in superior incision group due to poorer surgical accessibility than temporal group, it may affect on postoperative IOP. RESULTS: The mean preoperative IOP of Group 1 (59 eyes) and Group 2 (41 eyes) were 14.6 mmHg and 14.3 mmHg respectively. At postoperative 1 day, the IOP decreased in both groups by 14.2 mmHg and 14.0 mmHg respectively (p>0.05), and at 3 days, 13.1 mmHg and 13.2 mmHg respectively (p<0.05). And from then on, there was no statistically significant change to 3 months. The mean IOP of postoperative 3 months was 12.9 mmHg in both groups; decreased to 1.7 mmHg and 1.4 mmHg respectively compared to preoperative value (p<0.05). In all periods of this study, there was no significant difference between two groups and between two methods of measurement. CONCLUSIONS: These results suggest that in case of uncomplicated senile cataract, sutureless clear corneal phacoemulsification with foldable posterior intraocular lens implantation reduces the IOP in short term follow up period.
Astigmatism ; Axis, Cervical Vertebra ; Cataract Extraction ; Cataract* ; Follow-Up Studies ; Intraocular Pressure* ; Lens Implantation, Intraocular ; Phacoemulsification

OBJECTIVE: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. METHODS: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. RESULTS: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. CONCLUSIONS: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.
Chin ; Dental Occlusion ; Malocclusion ; Molar ; Orthodontics ; Overbite ; Treatment Outcome

BACKGROUND: This experiment was performed to determine the effect of polyphenolic (-)-epigallocatechin (EGCG), the most abundant catechin of green tea, given at reperfusion period. METHODS: Isolated rat hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. Green tea extract (GT) was perfused with the following concentrations; 0, 0.5, and 1 micrometer (GT-O, GT-0.5, and GT-1, respectively). In a next experiment, hearts were assigned randomly to one of the following groups; Control, EGCG-1 (1 micrometer of EGCG), and EGCG-10 (10 micrometer of EGCG). GT and EGCG were perfused for a period of 5 min before and 30 min after reperfusion. For comparison of cardioprotection among groups, morphometric measurement was performed by 2,3,5-triphenyltetrazolium chloride staning. RESULTS: GT 1 micrometer (10.3 +/- 2.1%, P < 0.05) significantly reduced infarct volume as a percentage of ischemic volume compared to untreated hearts (27.4 +/- 1.1%). EGCG 10 micrometer (13.2 +/- 4.0%) significantly reduced myocardial infarction compared to control hearts (27.2 +/- 1.4%, P = 0.002). After 2 h of reperfusion, cardiodynamic variables, including left ventricular developed pressure, rate-pressure produce, +dP/dt(max), and -dP/dt(min) were significantly improved by 10 micrometer of EGCG compared to control hearts (P = 0.01, 0.016, 0.009, and 0.019, respectively). CONCLUSIONS: EGCG treatment at an early reperfusion period reduces myocardial infarction and improves cardiodynamics in isolated rat hearts.
Animals ; Catechin ; Heart ; Ischemia ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Rats ; Reperfusion ; Reperfusion Injury ; Tea ; Tetrazolium Salts

BACKGROUND: This experiment was performed to determine the effect of polyphenolic (-)-epigallocatechin (EGCG), the most abundant catechin of green tea, given at reperfusion period. METHODS: Isolated rat hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. Green tea extract (GT) was perfused with the following concentrations; 0, 0.5, and 1 micrometer (GT-O, GT-0.5, and GT-1, respectively). In a next experiment, hearts were assigned randomly to one of the following groups; Control, EGCG-1 (1 micrometer of EGCG), and EGCG-10 (10 micrometer of EGCG). GT and EGCG were perfused for a period of 5 min before and 30 min after reperfusion. For comparison of cardioprotection among groups, morphometric measurement was performed by 2,3,5-triphenyltetrazolium chloride staning. RESULTS: GT 1 micrometer (10.3 +/- 2.1%, P < 0.05) significantly reduced infarct volume as a percentage of ischemic volume compared to untreated hearts (27.4 +/- 1.1%). EGCG 10 micrometer (13.2 +/- 4.0%) significantly reduced myocardial infarction compared to control hearts (27.2 +/- 1.4%, P = 0.002). After 2 h of reperfusion, cardiodynamic variables, including left ventricular developed pressure, rate-pressure produce, +dP/dt(max), and -dP/dt(min) were significantly improved by 10 micrometer of EGCG compared to control hearts (P = 0.01, 0.016, 0.009, and 0.019, respectively). CONCLUSIONS: EGCG treatment at an early reperfusion period reduces myocardial infarction and improves cardiodynamics in isolated rat hearts.
Animals ; Catechin ; Heart ; Ischemia ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Rats ; Reperfusion ; Reperfusion Injury ; Tea ; Tetrazolium Salts

OBJECTIVE: The authors present eight cases of immediate post-operative epidural hematomas(EDHs) adjacent to the craniotomy site, describe clinical details of them, and discuss their pathogenesis. METHODS: Medical records of eight cases were retrospectively reviewed and their clinical data, operation records, and radiological findings analyzed. Any risk factors of the EDHs were searched. RESULTS: In 5 of 8 cases, adjacent EDHs developed after craniotomies for the surgical removal of brain tumors. Three cases of adjacent EDHs developed after a pterional approach and neck clipping of a ruptured anterior communicating artery aneurysm, a ventriculoperitoneal shunt, and a craniotomy for a post-traumatic EDH, respectively. In all eight cases, brain computed tomography (CT) scans checked immediately or a few hours after the surgery, revealed large EDHs adjacent to the previous craniotomy site, but there was no EDH beneath the previous craniotomy flap. After emergent surgical removal of the EDHs, 7 cases demonstrated good clinical outcomes, with one case yielding a poor result. CONCLUSION: Rapid drainage of a large volume of cerebrospinal fluid or intra-operative severe brain collapse may separate the dura from the calvarium and cause postoperative EDH adjacent to the previous craniotomy site. A high-pressure suction drain left in the epidural space may contribute to the pathogenesis. After the craniotomy for brain tumors or intracranial aneurysms, when remarkable brain collapse occurs, an immediate postoperative brain CT is mandatory to detect and adequately manage such unexpected events as adjacent EDHs.
Brain ; Brain Neoplasms ; Cerebrospinal Fluid ; Craniotomy* ; Drainage ; Epidural Space ; Hematoma* ; Intracranial Aneurysm ; Medical Records ; Neck ; Retrospective Studies ; Risk Factors ; Skull ; Suction ; Ventriculoperitoneal Shunt

PURPOSE: Perinatal mortality rates have been used as a summary statistic for evaluating child health and medical status. Neonatal mortality rates have decreased over the past 30 years in Korea. To understand the current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area, we have studied about neonatal gastrointestinal diseases with their clinical features, postoperative outcome, and mortality rates. METHODS: A clinical analysis on 202 neonates who underwent neonatal surgery from January 1996 to July 2003 at Pusan National University, Kyungpook National University, Youngnam University, and Daegu Catholic University was carried out. RESULTS: The main diseases of surgical conditions were anorectal malformation (23.8%), atresia/ stenosis of midgut (13.4%) and pyloric stenosis (13.4%). The male to female ratio was 2.8:1. Thirty-five cases (17.0%) had one or more associated anomalies including congenital heart disease, cryptoorchidism, hydronephrosis, and chromosomal anomaly. Twenty cases (10.0%) were diagnosed by antenatal ultrasound. Patients with esophageal atresia had the longest hospitalization for 54.6 days. Postoperative complications occurred in 18 cases (8.9%). The main postoperative complications were wound infection (3.5%) and anastomotic leakage (2.5%). Overall mortality was 5.9%. Diaphragmatic hernia showed the highest mortality rate (37.5%), and esophageal atresia (28.6%) and omphalocele (20.0%) were followed. CONCLUSION: The current status of neonatal surgical gastrointestinal diseases in Daegu?Busan area has improved because the disease categories are various, postoperative complications and mortality rates are decreased.
Anastomotic Leak ; Busan ; Child ; Child Health ; Constriction, Pathologic ; Daegu ; Esophageal Atresia ; Female ; Gastrointestinal Diseases* ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Hernia, Umbilical ; Hospitalization ; Humans ; Hydronephrosis ; Infant ; Infant Mortality ; Infant, Newborn ; Korea ; Male ; Mortality ; Perinatal Mortality ; Postoperative Complications ; Pyloric Stenosis ; Ultrasonography ; Wound Infection

Ganglioneuroma is generally considered to be the benign mature from of tumor arising from neural crest tissue. The great chain of sympathetic ganglia including the adrenal medulla accounts for the origin of most of ganglioneuroma. Complete surgical excision of adrenal ganglioneuroma is the treatment of choice. Herein we report a cases of adrenal ganglioneuroma in a 17-year-old male which is confirmed by surgical exploration and histopathologic examination.
Adolescent ; Adrenal Medulla ; Ganglia, Sympathetic ; Ganglioneuroma* ; Humans ; Male ; Neural Crest