PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

PURPOSE: To evaluate the US findings of soft tissue hemangiomas in extremities and to correlate the echo-pattern with MR signal characteristics of hemangiomas. MATERIALS AND METHODS: We retrospectively studied forty-two patients either with pathologically proven cases or with characteristic features of hemangiomas on MRI, US and plain film. Hemangiomas were divided into two types according to the locations;subcutaneous and intramuscular. Analytic points on US and MR findings were gross morphology of the mass, internal echo-pattern or signal characteristics. We correlated the echo-pattern with MR signal characteristics in hemangiomas. RESULTS: Subcutaneous hemangiomas revealed homogeneously anechoic mass on US, which were well correlated with MR signal characteristics' homogeneous low singnal intensity(SI) on Tl-weighted image(WI) and high SI on T2-WI. Intramuscular hemangiomas showed heterogeneously mixed echoic masses on US. An anechoic component on US corresponded to dilated vascular channels on MRI. The signal intensity of intramuscular hemangioma was less than that of subcutaneous fat on T1-WI and greater than that of fat on T2-WI. Both types of hemangiomas had tubular or lace-like appearance with interspersed fibrofatty septa. CONCLUSION: The echo-patterns in US were well associated with MR signal characteristics on MRI. Regarding US and MR features, intramuscular hemangiomas were different to subcutaneous hemangiomas.
Extremities* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Subcutaneous Fat

BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

PURPOSE: The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases. METHODS: A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention. RESULTS: The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined. CONCLUSION: A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.
Adaptation, Psychological ; Adult ; Attitude to Health ; Cardiovascular Diseases/*psychology ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; *Resilience, Psychological

Objectives: This study aims to investigate the effect of determinants on the number of remaining teeth in Korean adults using a machine learning-based decision tree analysis. Methods: The study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) and a decision-tree analysis to explain the causes for the number of remaining teeth in adults. The determinants for the study are sex, age, house income, education level, diabetes, BMI, smoking, alcohol drinking, tooth brushing per day, and periodontitis. Results: Age had the most significant effect on the number of remaining teeth, followed by house income. Conclusions This research is meaningful as it provides a systematic index in the number of remaining teeth in Korean adults based on a combination of numerous variables. These variables have already been validated against the results of previous studies that have attempted to elucidate new variables affecting the number of remaining teeth.

Purpose: This study aimed to identify the early sedation depth in the first 48 hours of mechanical ventilation and its relationship to clinical outcomes to promote the transition to light sedation. Methods: This retrospective single-center cohort study was conducted in two medical intensive care units (MICUs) at a general tertiary hospital, using a standardized sedation protocol. To investigate the early sedation depth, the Sedation Index was used, which can indicate changes over the first 48 hours. Patients were divided into three groups based on tertiles of Sedation Index. The primary outcome was mortality at 30, 90, and 180 days. The secondary outcomes included length of stay in the ICU and ventilator-free days. Kaplan-Meier analysis and multivariable Cox regression were conducted to compare factors influencing mortality. Results: This study included 394 patients. The deepest sedation group showed more severe illness, delirium, and deeper sedation at admission (p < .001). The survival curve decreased as sedation increased, even within the light sedation levels. In the deepest sedation group, 30-day mortality (hazard ratio [HR] 2.11, 95% confidence interval [CI] 1.33–3.34), 90-day mortality (HR 2.00, 95% CI 1.31–3.06), and 180-day mortality (HR 1.77, 95% CI 1.17–2.67) increased. The length of stay in the ICU and ventilator-free days did not show statistical differences. Conclusions These results indicate that early deep sedation is a modifiable factor that can potentially affect mortality. The protocol for inducing the transition into light sedation must comply with recommendations to improve clinical outcomes.

PURPOSE: The use of antiepileptic drugs for the seizure control has been a remarkable breakthrough. However, excessive body weight gain is a common side effect of some antiepileptic drugs. Topiramate is a novel and highly effective antiepileptic drug that has been associated with weight loss in some patients. This study was undertaken to compare the change of body weight in children treated with valproic acid and topiramate for epilepsy. METHODS: Children who took medications for epilepsy with either valproic acid or topiramate were recruited. We collected the data of the initial weight and the follow-up weight on average, 10 months documented in the medical records. We analyzed the change of body weight due to antiepileptic drugs in the study subjects. RESULTS: Statistically significant weight gains after treatment with valproic acid were observed(mean+/-SD, 3.7+/-3.2 kg). However, there have nearly no change of body weight after the treatment with topiramate(mean+/-SD, -0.9+/-2.3 kg). There were significant difference in weight changes between two groups of two different antiepileptic drug. CONCLUSION: This study showed that topiramate caused little weight gain in children with epilepsy. Antiepileptic drugs should be selected by individual patient's characteristics.
Anticonvulsants* ; Body Weight* ; Child* ; Epilepsy ; Follow-Up Studies ; Humans ; Medical Records ; Seizures ; Valproic Acid ; Weight Gain ; Weight Loss

The authors have experienced a case of histiocytosis-X. A 7-year-old male patient had three tender masses, one on the right parietal region, another on the left parietal region, the other on the left occipital region and revealed exophthalmus on his left side. Plain skull films showed multiple punched out skull defects and on lumbar spine films, collapse of body of second lumbar vertebra was detected. Among the masses, the largest right parietal one was excised totally. The final diagnosis revealed histiocytosis-X on pathologic basis and he was given subsequent chemotheraphy.
Child ; Diagnosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Male ; Rabeprazole ; Skull ; Spine

The purpose of this study was to evaluate the color stability of resin cements with accelerated test. Four dual curing resin cements: Panavia-F (KURARAY), Duolink (BISCO), Variolink-II (Ivoclar Vivadent), and RelyX Unicem (3M ESPE) and 1 self curing resin cement: Resiment CE (j. l. Blosser) were used in this study. In control group, Gradia Anterior (GC) composite resin and Tescera Dentin (Bisco) indirect composite were used. Ten disk shape specimens were made from each resin cement. The specimens were subjected to an accelerated aging process in a refrigerated bath circulator at 60degrees C for 15 and 30 days. Spectrophotometric analyses were made before and after 15 days and 30 days of accelerated aging time. The color characteristics (L*, a*, b*) and the color difference (DeltaE*) of the specimens before and after immersion were measured and computed. Regardless of type of the resin cements, L* value was decreased and a* value was increased, but there were no significant difference. But b* value was increased significantly (p < 0.05). Tescera inlay showed least color change (p < 0.05), but Gradia showed notable color change after 15 days. After 30 days on accelerated aging, DeltaE* value was increased (Panavia-F < Variolink-II < Resiment CE < Duolink < Unicem) (p < 0.05), but there were no significant difference among Panavia-F, Variolink-II, and Resiment CE groups. After 30 days of accelerated aging, DeltaE* value of all resin cements were greater than 3.0 and could be perceived by the human eye.
Aging ; Baths ; Composite Resins ; Dentin ; Dentin-Bonding Agents ; Eye ; Humans ; Immersion ; Inlays ; Resin Cements

The purpose of this study was to assess the background color-interceptive ability and opacity of opaque shade composites (Universal composite, Filtek Z350, Charisma, Clearfil ST, Palpaque Estelite, Esthet-X, and Metafil Flo). Twenty four background specimens (diameter 5.5 mm, thickness 3.0 mm) with Root dentin Mustard (Bisco, Schaumburg, IL, USA) were made. The CIE L*a*b* value of background specimens was measured by a spectrophotometer (Spectrolino, GretagMacbeth, Regensdorf, Switzerland). Three specimens in every group were filled on the background specimens. The surface color of samples was measured by a spectrophotometer in 3.0 mm and every thickness to 0.5 mm while grinding. The color difference in the background color along with 3.0 mm specimen gauged the masking effect in each thickness while grinding and polishing. The opacity was calculated in 1 mm thick specimens. The opacity was in the decreasing order of Clearfil ST, Metafil Flo, Filtek Z350, Palpaque Estelite, Universal composite, Charisma, and Esthet-X (p < 0.05). As the thickness get reduced, L* value showed decreasing, a* increasing tendency. The surface color difference between pair of the 3.0 mm thick specimen and after grinding in same opaque resin was above 3.3 except Clearfil ST and Metafil Flo. The color difference (DeltaE*) between pair of background specimen and opaque resin builtup specimen showed more than 10.0 regardless kinds and thickness. The variance in opacity characteristics and color of the opaque composites is dependent upon manufacturer. When using the opaque resin, the optical properties of each material must be considered as well as cavity.
Composite Resins* ; Dentin ; Masks* ; Mustard Plant