To assess the safety of playground equipments in the elementary schools of Taegu, a site visit was made to 117 elementary schools out of 119 schools between 1st and 30th April 1991. Safety criteria were developed on the bases of Massachusetts' Playground Safety Check List, standard height of Korean children of 6-12 years old, and source book for designing playground equipments. There were eleven different kinds of playground equipments installed in 117 schools but the number of equipments was about 50-60% of the minimum requirement set by the Ministry of Education except chin-up bar. Among the installed equipments, 47.3% of swings, 16.6% of parallel bars, 20.0% of monkey bars, and 16.0% of slides were broken down. None of the swings, slides, seesaws, monkey bars, and sandboxes met the safety criteria to the full but 59.0 of chin-up bars, 31.4% of parallel bars, and 13.5% of stumps met the criteria fully. The proportions of equipments that were dangerous for children to play on were 26.4% for slides, 20.0% for monkey bars, 11.6% for seesaws, 10.4% for parallel bars, 9.85 for sandboxes, 7.4% for swings and stumps, and 3.9% for chin-up bars. The rests were either in need of repair of broken down. It was revealed by this survey that the playground equipments were too short in number to meet the minimum requirement, designs and size were not standardized, and many of the equipments were involved with the risk of child accidents. Therefore, a safety standard for the playground equipments should be developed and the existing equipments should be repaired immediately.
Child ; Daegu* ; Education ; Haplorhini ; Humans

BACKGROUND: Perioperative hypothermia can develop easily during shoulder arthroscopy, because cold irrigation can directly influence core body temperature. The authors investigated whether active warming and humidification of inspired gases reduces falls in core body temperature and allows redistribution of body heat in patients undergoing arthroscopic shoulder surgery under general anesthesia. METHODS: Patients scheduled for arthroscopic shoulder surgery were randomly assigned to receive either room temperature inspired gases using a conventional respiratory circuit (the control group, n = 20) or inspired gases humidified and heated using a humidified and electrically heated circuit (HHC) (the heated group, n = 20). RESULTS: Core temperatures were significantly lower in both groups from 30 min after anesthesia induction, but were significantly higher in the heated group than in the control group from 75 to 120 min after anesthesia induction. CONCLUSIONS: In this study the use of a humidified and electrically heated circuit did not prevent core temperature falling during arthroscopic shoulder surgery, but it was found to decrease reductions in core temperature from 75 min after anesthesia induction.
Anesthesia ; Anesthesia, General ; Arthroscopy ; Body Temperature ; Cold Temperature ; Gases ; Hot Temperature ; Humans ; Hypothermia ; Shoulder

Intradermal injections of indigo carmine for sentinel node mapping are considered safe and no report of an adverse reaction has been published. The authors described two cases of profound hypotension in women that underwent breast-conserving surgery after an intradermal injection of indigo carmine into the periareolar area for sentinel node mapping.
Breast Neoplasms ; Female ; Humans ; Hypotension ; Indigo Carmine ; Indoles ; Injections, Intradermal ; Mastectomy, Segmental ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

BACKGROUND: The arterial switch operation (ASO) has become a procedure of choice for transposition of the great arteries (TGA) with or without ventricular septal defect (VSD). In spite of current low surgical mortality in immediate surgical period, there are potential problems of late morbidity and mortality. In this study, we evaluate the prevalence and severity of aortic insufficiency (AI) and associated factors with AI. METHOD: We retrospectively reviewed medical records and echocardiogram of 125 patients (M89, F36) underwent ASO for TGA at Seoul National University Children's Hospital from July, 1987 to June, 1997. To evaluate for associated factors, we divided patients of TGA to four hemodynamic groups (Group I, simple TGA (n-53); Group II, associated with ventricular septal defect (VSD) (n-50); Group III, associated with VSD and PS (n-18); Group IV, associated with PS (n-4)). Grade of AI was assessed by color Doppler analysis (Perry's et al). RESULTS: Total prevalence rate of AI was 35.2% (31/88) and grade of AI were mild in 61%, moderate in 39%. The incidence of AI in each group was: Group I 25.0% (10/40), Group II 26.0% (9/36), Group III 92.0% (12/13). According to this study, pulmonary stenosis was the only significant factor to AI. During follow-up (39+/-24 Months), in spite of the normal left ventricular function in most patients with AI, a few patients (3 cases) suffered from progressive AI and some moderate AI patients (2 cases) showed slightly decreased LV function. Two moderate and progressive AI lossed. CONCLUSION: In this study, AI (after ASO) was not uncommon and pulmonary stenosis was an important factor to AI. In some cases, AI became worse and developed decreased LV function. This suggests that meticulous follow-up after ASO is necessary.
Arteries* ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Incidence ; Medical Records ; Mortality ; Prevalence ; Pulmonary Valve Stenosis ; Retrospective Studies ; Seoul ; Ventricular Function, Left

PURPOSE: Myocardial scintigraphy has been reported to be useful in adults, but its usefulness in children is limited. This study was done to determine the feasibility and accuracy of 99mTc-MIBI SPECT(sestamibi , methoxy-isobutyl-isonitrarite myocardial single emirs sion computed tomography, Dp-SPECT) after dipyridamole infusion to detect coronary obstructive lesions in Kawasaki disease(KD). METHODS: Dp-SPECT was performed in 21 control(group 1), 8 with coronary aneurysm(group 2) and 16 with coronary obstructive lesion(group 3) in children with KD. The spatial distribution of Dp-SPECT was determined and analyzed visually. Group 2 and 3 underwent coronary angiogram within 3 months of Dp-SPECT. RESULTS: Chest pain occurred more frequently in group 2. No subject required supplemental oxygen or were complicated by myocardial ischemia. The specificity of Dp-SPECT for control subject was 95% & 62% if using a cut-off criterion of abnormality, utilizing moderate or mild perfusion defect, respectively. The false positive rate was high in anterior, apical and anteroseptal segments but not related to age. The abnormalities found on Dp-SPECT was observed in 25% of aneurysmal coronary arteries but not related to its size. The sensitivity, specificity, and accuracy of Dp-SPECT was 100%, 84.5% and 79% in coronary stenosis greater than 75%, respectively. CONCLUSION: The interpretation of Dp-SPECT should be careful in KD because of discrepancies between Dp-SPECT & angiography, But DP-SPECT is noninvasive and easily applicable. It monitors the occurrence and progression of coronary stenosis due to KD. Besides Dp-SPECT may be applicable after arterial switch operation or to myocardial sinusoid.
Adult ; Aneurysm ; Angiography ; Chest Pain ; Child ; Coronary Stenosis ; Coronary Vessels ; Dipyridamole ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia* ; Myocardial Perfusion Imaging ; Oxygen ; Perfusion* ; Sensitivity and Specificity

Amygdalin is known as vitamain B17, and it was called laetrile. Amygdalin is composed of two molecules of glucose, one molecule of benzaldehyde which induces an analgesic action, and one molecule of hydrocyanic acid which is an anti-neoplastic compound. Amygdalin had been used to treat cancers and relieve pain. In order to evaluate whether the analgesic action of amygdalin is related with descending pain control system, we performed patch clamp study. In the present study, the modulatory effects of amygdalin on glycine- and glutamate-induced ion currents in periaqueductal gray (PAG) neurons were investigated using the nystatin-perforated patch clamp method. Continuous application of lipopolysaccharides (LPS) on PAG neurons resulted in increased glycine-induced ion current, and in decreased glutamate-induced ion current. In contrast, continuous application of amygdalin with LPS resulted in decreased glycine-induced ion current increased by LPS, and increased glutamate- induced ion current decreased by LPS in concentration- and time-dependent fashion. These results demonstrate that amygdalin modulates neuronal activity of PAG by modulation of glycine and glutamate. Based on the present results, it can be suggested that amygdalin participates in the regulation of the descending pain control system in the level of PAG neurons. The present study demonstrated that activation of the descending pain control system is one of the possible analgesic mechanisms of amygdalin.
Amygdalin ; Animals ; Benzaldehydes ; Cyclooxygenase 2 ; Glucose ; Glutamic Acid ; Glycine ; Hydrogen Cyanide ; Lipopolysaccharides ; Neurons ; Periaqueductal Gray ; Rats

PURPOSE: To evaluate the possibility that human muscle derived stem cells (hMDSCs) can be differentiated into neurons in vitro. MATERIAL AND METHODS: Muscle derived stem cells were isolated from the hamstring muscles during the anterior cruciate ligament reconstruction by preplate technique. For the characterization of these cells, desmin staining, CD 34, Sca-1, CD 29 using the Flow cytometry were performed. In the experimental group, neuronal induction media was added to differentiate hMDSCs to neuronal cells. These cells were evaluated by neuronal markers such as neuron-specific enolase (NSE), neurofilament (NF), TrkA using immunocytochemistry. For the control group, no induction media was added. Statstical analyses were performed by use of Kruskal-Wallis H test and Student-Newman-Keuls test (P<0.01). RESULT: Desmin staining was positive in 92.3+/-6%. Flow cytometry was negative for CD 34 and Sca-1. However it was positive for CD 29. (69.4+/-10%). The immunocytochemical result revealed NSE, NF and TrkA positive with 63.2+/-2.3%, 59.2+/-2.5%, 55+/-2.4% respectively. However, these were negative in the control group. CONCLUSION: Our observations indicate that hMDSCs have the capacity to differentiate into neurons in a specialized culture media.
Anterior Cruciate Ligament Reconstruction ; Culture Media ; Desmin ; Flow Cytometry ; Humans* ; Immunohistochemistry ; Muscles ; Neurons* ; Phosphopyruvate Hydratase ; Stem Cells*

PURPOSE: In Korea, the incidence of breast cancer peaks in the fifth decade, which is younger than that observed in the Western world. We conducted this study to compare the clinical characteristics and prognostic factors of breast cancer in women < 35 and ≥35 years old.METHODS: The medical records of 969 patients treated for breast cancer at the Gil Medical Center from 2008 through 2012 were reviewed. Tumor characteristics, surgical methods, and adjuvant therapies were compared in two groups.RESULTS: Number of childbirths, family history, the proportion of postmenopausal women were lower among those aged < 35 years. However, tumor size, number of metastatic lymph nodes, and surgical procedures were similar in two groups. The rate of triple negative status in younger patients was higher than in older patients. Adjuvant chemotherapy was effective in patients positive for hormone receptors and no lymph nodal invasion, and it was effective in patients negative for hormone receptors and lymph nodal invasion in patients aged >35 years old. Postoperative radiotherapy was statistically effective in patients aged < 35 and ≥35 years old that underwent breast-conserving surgery. Pregnancy were significantly associated with survival in younger patients. While lymph node stage, presence of progesterone receptor, and triple negative status were significantly associated with survival on older patients.CONCLUSION: The prognostic factors of breast cancer in patients younger than 35 years old were pregnancy. Triple negative status rate was higher in younger patients than in older patients. Adjuvant therapy had similar effects in patients aged < 35 or ≥35 years old.
Breast Neoplasms ; Breast ; Chemotherapy, Adjuvant ; Female ; Humans ; Incidence ; Korea ; Lymph Nodes ; Mastectomy, Segmental ; Medical Records ; Parturition ; Pregnancy ; Prognosis ; Radiotherapy ; Receptors, Progesterone ; Western World ; Young Adult

PURPOSE: The activity of mammary stem cells (MaSCs) is essential to mammary growth, differentiation and regeneration in cycles of pregnancy, lactation, and involution. The capability to recruit the mammary gland through the cycles is attributed to stem cells. It was shown that the intraductal (i.duc) injection of pegylated liposomal doxorubicin (PLD) to multiparous FVB/N mice was associated with a significantly reduced outgrowth potential of mammary gland cells. We have explored i.duc PLD's effect on stem cell number and function in mouse mammary gland and aldehyde dehydrogenase (ALDH)'s availability as a mouse MaSC marker.METHODS: The total mammary epithelium was purified from 6 to 8-month-old FVB/N control and i.duc PLD-administered mice treated twice and analyzed by flow cytometry and limiting dilution cleared mammary fat pad transplants.RESULTS: There was no significant difference in the proportions of stem cell-enriched population (CD49(fhigh)CD24(med)) between control and i.duc PLD-treated groups. However, we found a significant reduction in the outgrowth potential of CD49(fhigh)CD24(med) and CD49(fhigh)CD24(med)ALDH(+) cells from i.duc PLD-treated mammary glands. We discovered that adding ALDH to CD49(fhigh)CD24(med) had the possibility of better marker selection for MaSC of mice.CONCLUSION: We present i.duc administration of PLD to reduce MaSC function, but not the number; and ALDH activity may add further selection of MaSCs to CD49f CD24 in mouse mammary glands. Screening of chemotherapeutic drugs or other natural products by this method of stem cell analysis may provide safe i.duc treatment in breast cancer.
Adipose Tissue ; Aldehyde Dehydrogenase ; Animals ; Biological Products ; Breast Neoplasms ; Doxorubicin ; Epithelial Cells ; Epithelium ; Female ; Flow Cytometry ; Humans ; Infant ; Lactation ; Mammary Glands, Human ; Mass Screening ; Methods ; Mice ; Pregnancy ; Regeneration ; Stem Cells

PURPOSE: Watson for Oncology (WFO) is a computing system for considering treatment option with patients. The aim of this study is to determine the concordance rate of WFO and tumor board in treatment options of breast cancer.METHODS: One hundred and seventy breast cancer patients who were treated at Gachon University Gil Medical Center (GMC) from December 2016 to March 2018 were investigated. “Concordance” is defined that treatment provided by GMC tumor board and WFO-provided treatments (Recommend or For Consideration) were coincide. “Discordance” is defined that treatment provided by GMC tumor board and WFO-provided treatments (Not Recommended or Not Available) were coincide.RESULTS: In chemotherapy, of the total 170 patients, 23 patients were excluded, and the concordance rate was compared in 147 patients. Concordance rate was 93% (136/147). In the 11 patients who were discordant, seven patients complied with the treatment proposed by GMC tumor board due to insurance problems and age, and two patients did not follow the treatment proposed by WFO due to pregnancy and patient's choice, and one patient chose a treatment determined by WFO, last one patient was not treated with chemotherapy because it was not considered to be clinically necessary. In radiotherapy, the overall agreement rate was as high as 99% (147/148).CONCLUSION: Through this study, we found that many of the treatment proposals provided by WFO are highly reliable. Although the overall agreement is high in the radiotherapy regimen, the indication for radiotherapy by WFO is more aggressive and hypofractionated high dose intensity radiotherapy is growing trend by WFO.
Breast Neoplasms ; Breast ; Drug Therapy ; Humans ; Insurance ; Pregnancy ; Radiotherapy