Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.
Age Distribution ; alpha-Fetoproteins ; Child* ; Choriocarcinoma ; Drug Therapy ; Dysgerminoma ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Germinoma ; Humans ; Lymph Nodes ; Mediastinum ; Neoplasms, Germ Cell and Embryonal* ; Omentum ; Pineal Gland ; Pleura ; Pregnancy ; Radiotherapy ; Scrotum ; Spine ; Teratoma

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

BACKGROUND AND PURPOSE: Wandering is one of the most common behavioral and psychological symptoms of dementia, and associated with some of the adverse outcomes in dementia, such as getting lost or even death. The etiology of wandering is not yet clearly known. As depression and wandering are both very common among the patients with dementia, this study examined the relationship between the depression and wandering among the community dwelling patients with dementia. METHODS: Fifty community dwelling patients diagnosed with dementia were included in this study if they had primary family caregiver, older than age 18 in Seoul, South Korea. The Geriatric Depression Scale, Korean Version (GDS-K), Korean Version of the Mini-Mental State Examination (K-MMSE) and Korean Version of Revised Algase Wandering Scale-Community Version (K-RAWS-CV) were used to measure the severity of depression, cognitive function and wandering. RESULTS: Thirty percents of the patients showed wandering. Mean score of GDS-K was significantly higher in wanderers than non-wanderers. Severity of depression was significantly correlated with the total score of K-RAWS-CV and subscales of persistent walking, repetitive walking, eloping behavior, and mealtime impulsivity in whole sample. K-MMSE score also was related to wandering behavior. The prevalence odds ratio for wandering in depressed patients compared with undepressed group was 8.386 (95% confidence interval: 1.978-35.561). CONCLUSIONS: This study implicates that not only cognitive impairment but also psychosocial aspects should be considered in wandering patients with dementia and suggests assessing the depression in patients would be helpful in identifying the causes of wandering.
Caregivers ; Dementia* ; Depression* ; Humans ; Impulsive Behavior ; Korea ; Meals ; Odds Ratio ; Prevalence ; Seoul ; Walking ; Wandering Behavior

PURPOSE: The purpose of this study was to identify the relationship between self-esteem and meaning of life in higher grade elementary school students. METHODS: Four hundred eighty four elementary school students in their 4 ~ 6th-grade at S, G and C City were recruited by convenient sampling. Data were collected from August to October, 2008 using a self-reported questionnaire. The collected data were analyzed by the SPSS/WIN 12.0 program with mean, standard deviation, t-test, ANOVA, Duncan's test, and Pearson's correlation. RESULTS: The average score of meaning of life was 3.07 +/- 0.38 and that of self-esteem was 3.43 +/- 0.62. There were significant differences in self-esteem according to variables region and religion, and in meaning of life scores according to variables region, grade, sex and religion. There was a significant positive correlation between self-esteem and meaning of life. CONCLUSION: Self-esteem and meaning of life should be considered as important factors for healthy development in the elementary school period. Self-esteem should be considered as a main content in developing programs for finding meaning of life for higher grade elementary school students.
Humans ; Religion and Sex ; Self Concept ; Surveys and Questionnaires

OBJECTIVE: In order to compare the clinical effect and frequency of side effects between d-penicillamine and bucillamine, a chemical derivative of d-penicillamine, we conducted a randomized, controlled clinical trial. METHODS: 22 and 24 patients were allocated in each treatment arm, after stratification according to functional class, anatomical stage, and concomittant steroid use. We evaluated tender joint count, swollen joint count, tenderness score, duration of morning stiffness, and grip strength every 4 weeks. Westergren ESR, hemoglobin, leucocyte and platelet count were also checked every 4 weeks, and C-reactive protein(CRP)quantitation and rheumatoid factor(RF) titration were checked at baseline and 16 weeks. Study period spanned 16 weeks. RESULTS: At the end of the trial, both swollen joint count and tenderness score decreased significantly from baseline in both groups, whereas tender joint count decreased siginficantly in bucillamine-treated group only. Grip strength also improved significantly in bucillamine group. Duration of morning stiffness decreased in both groups. When we arbitrarily defined response as more than 30% decrease in both tender and swollen joint count from baseline, 27% of bucillamine group and 33% of d-penicillamine group responded. The response rate did not differ significantly between the 2 groups. ESR and RF decreased in both groups, whereas CRP decreased significantly only in bucillamine group. The frequency of side effects lasting more than 1 day and possibly related to drug was 14% and 37% in bucillamine and d-penicillamine group, respectively. The difference was statistically not significant. CONCLUSIONS: Bucillamine is as effective as d-penicillamine in the treatment of rheumatoid arthritis. The frequency of side effect tended to be lower.
Arm ; Arthritis, Rheumatoid* ; Hand Strength ; Humans ; Joints ; Penicillamine* ; Platelet Count

PURPOSE: This study attempted to identify influential variables on types of smoking in adult smokers, which have been derived from Q-study. METHODS: A survey was conducted with 328 adult smokers at community settings in Seoul, South Korea from April 2006 to July 2006. To identify the influential variables related to smoking, variables from the Trans-theoretical model(i.e., self-efficacy for smoking abstinence, smoking temptation, process of change, decisional balance(pros and cons)) and nicotine dependency were analysed by ANOVA. Post-comparison tests were also done. RESULTS: The scores of nicotine dependency and smoking temptation were higher in habitual craving types than any other types, while the scores of self-liberation and self-efficacy for smoking abstinence were higher in self control types than any other types. CONCLUSION: Specific smoking intervention methods for each of the smoking types needs to be developed, based on how different groups of individuals gets into a decisions to quit smoking within their contexts.
Adult ; Dependency (Psychology) ; Humans ; Nicotine ; Republic of Korea ; Smoke ; Smoking

PURPOSE: The purpose of this study was to explore characteristics of eating behavior according to level of functional status of elders with dementia (EWD), and to examine feeding time, change in food intake and body mass index (BMI) according to eating behavior. METHODS: Participants were 149 EWD residing in long-term care facilities located in Seoul or Gyeonggi province and evaluated using the Mini-Mental State Exam-Korean version, Korean version-Activities of Daily Living, and Eating Behavior Scale (EBS). Feeding time, change in food intake, and BMI were also measured. Data were analyzed using SPSS 17.0, specifically descriptive statistics, ANOVA, and Chi-square test. RESULTS: Participants' mean EBS score was 10.43+/-6.01 and half of them (54.4%) needed moderate or total assistance while eating. The EBS score was significantly lower for elders with severe dementia compared to those with mild or moderate dementia; and elders with severe ADL dependence compared to those with mild or moderate ADL dependence. Lower EBS scores were related to longer feeding time, a greater the rate of participants with decreased food intake and 'underweight' BMI. CONCLUSION: Nursing intervention programs which are designed for EWD are needed to maintain functional eating skills and prevent negative consequences in this population.
Aged ; Aged, 80 and over ; Body Mass Index ; Dementia/*psychology ; Eating ; *Feeding Behavior ; Female ; Humans ; Long-Term Care ; Male ; Nursing Homes ; Time Factors

PURPOSE: The purpose of this study was to determine the current state of nursing intervention for maternal adaptation and its' effectiveness in Korea by utilizing a systematic review. METHODS: The PICO(Population-Intervention-Compar ator-Outcome) strategy was established, and 1,720 pieces of literature published during the last ten-year period from four electronic databases were reviewed. Eighteen references that met inclusion and exclusion criteria were finally selected for systematic review. The quality of references using critical appraisal checklist for experimental studies were evaluated, and then systematic review and meta-analysis were conducted. RESULTS: All 18 references were quasi-experimental research design. Most interventions were provided at the hospital and postpartum care center. Maternal adaptation interventions appeared to be of many types, and particularly maternal role education programs were the most common. Confidence in maternal role was used as the most common variable for the maternal adaptati on. Various interventions for helping maternal adaptation in the postnatal period improved maternal confidence, moth er-infant attachment, maternal satisfaction and mother-infant interaction effectively. CONCLUSION: A diversity of nursin g interventions in postnatal period improved various aspects of maternal adaptation. Randomized controlled trials and longitudinal studies are needed in order to verify the effect of interventions for maternal adaptation more clearly.
Checklist ; Electronics ; Electrons ; Humans ; Clinical Trial ; Korea ; Mothers ; Moths ; Postnatal Care ; Research Design

BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

PURPOSE: The aim of this study was to explore the effects of A-solution on halitosis and oral status in preoperative NPO patients. METHODS: A nonequivalent control group, non-synchronized pretest-posttest design was used in this study. The participants in this study were 66 patients who were admitted for gynecologic surgery. The experimental treatment was to give oral gargling with A-solution, blended essential oils and diluted with distilled water. To identify the experimental treatment effects, halitosis, salivary pH, and oral status were measured by a portable halitosis detector, visual analogue scale, Bromo Thymol Blue (BTB), Bromo Cresol Purple (BCP) test paper and oral assessment guide. Data were analyzed using chi2-test, t-test with PASW 18.0 version. RESULTS: Participants were homogeneous before experimental treatment. Objective halitosis in the experimental group, measured by a portable halitosis detector (t= -8.34, p<.001) was significantly lower than the control group. Subjective halitosis was significantly lower in the experimental group (t= -9.29, p<.001). Salivary pH was significantly different between two groups (t=8.81, p<.001). Oral status was significantly better in the experimental group (t= -13.31, p<.001). CONCLUSION: These findings indicate that oral gargling using A-solution is effective in reducing patient halitosis, and improving oral status.
Adult ; Female ; Genital Diseases, Female/surgery ; Halitosis/*prevention & control ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Mouthwashes/*therapeutic use ; Preoperative Care ; Saliva/chemistry