OBJECTIVE: The goal of this study was to review the etiologies, phathophysiology, clinical presentations and to compare the results of the surgical methods of subdural empyema especially in infants. PATIENTS AND METHODS: We reviewed the clinical data of five infantile subdural empyemas experienced in our hospital from 1993 to 1998 which were all surgically treated by craniotomy or burr hole trephination. We experienced five cases of infantile subdural empyema: two males and three females. The ages ranged from 40 days to 11 months. RESULTS: The etiologies of all five cases were unproven but all five cases had meningitis before the subdural empyemas were diagnosed. The causative organism in one was streptococcus pneumoniae, and the other were unknown. Two were treated with craniotomy(one with a good outcome and the other died) and three were treated with burr hole trephination(all three had a good outcome). CONCLUSION: Subdural empyema is a rapid progressing disease and it is important to detect and treat in the early stages of disease. The choice of surgical method must be based on the stage of the disease and its location in the cranial cavity.
Craniotomy ; Empyema, Subdural* ; Female ; Humans ; Infant* ; Male ; Meningitis ; Streptococcus pneumoniae ; Trephining

BACKGROUND: This study was performed to find the association between the depression and perception of obesity by adolescent girls in Jung Eup City, Chollapukdo. The data were collected by questionnaire from July to October, 1996. RESULTS: 1. While the obesity rate of the girls by BMI criteria was 6.0%, 41.1% of girls perceived that they were obese. 2. Forty-eight percent of respondents tried weight control already, and as the method of weight control 33.3% tried exercise, 27.2% reduced food, 23.6% avoided snack before going to bed. 3. while 39.3% among those whose BMI was lower than 20 and 54.2% among those with BMI 20-24 tried weight control, only 5.1% among those who perceived their bodies as slim tried weight control. 4. By the analysis of self-rating depression scale (SDS) only 14.8% was normal without depression and the rest showed high SDS scale; 36.9% as mild, 38.5% as moderate, and 9.7% as severe state of depression. 5. While no statistically significant difference of SDS scores by the size of BMI was shown, significant different of SDS scores was shown among groups with different perception of their obesity and practice of weight control. 6. As a result of stepwise multiple regression analysis, dieting, perceived body image, and body mass index were significantly associated with depression of the adolescent girls. CONCLUSION: Adolescent girls who perceived themselves overweight regardless of actual weight were more likely to diet than other girls. And these characteristics had an influence on the depression of the adolescents. It is suggested that appropriate education should be required to prevent thoughtless weight control of the adolescents and to maintain mental health of the adolescents.
Adolescent* ; Body Image ; Body Mass Index ; Surveys and Questionnaires ; Depression* ; Diet ; Education ; Female* ; Humans ; Mental Health ; Obesity* ; Overweight ; Snacks

Objectives: This study examined the current status of depression and related factors among children using community child center. Methods: A cross-sectional study selected children in grades 4-6 who used the Gwangju and Jeollanamdo community child center (n=224) using a convenience sampling method. General characteristics, family characteristics, children's emotional characteristics, children's school life environment and depression status were assessed using a self-reported questionnaire. Results: The average score of depression among children using community child center was 15.31±7.70 out of a total of 27. Fifty-eight (25.9%) children had depression above 22 points. Variables related to children's depression were shown as grade, subjective economic level awareness, after-school activities excluding local children's centers, presence of family members after school, and family structure. Conclusions The depression prevalence of children using community child center was higher. Policy support such as children's psychological support programs would be needed to reduce children's depression, and community child centers are expected to be effective in reducing children's depression if continuous child psychological support services are developed for children's mental health.

Masclura tricuspidata, also called as Cudrania tricuspidata, is one of the most common Moraceae family plants in East Asia. Its trivial name follows mulberry due to the similar morphology. Investigation of the bioactive constituents of M. tricuspidata leaves yielded a new xanthone derivative along with twenty known compounds through various chromatographic techniques. A new compound was defined as mascluraxanthone (3), a prenylated xanthone glucoside on the basis of 1D and 2D NMR and MS data. Twenty known compounds were identified as four xanthone derivatives (1-2 and 4-5), two flavans (6-7), six flavanol derivatives (8-13), a flavonone (14) and seven flavonol derivatives (15-21). Among the isolated compounds, flavanol and flavonoid derivatives with 3′,4′-OH groups showed antioxidant and anti-tyrosinase activities. Conclusively, the leaves of M.tricuspidata are rich in aromatic compounds including xanthones and flavonoids. In addition, these constituents showed antioxidant and anti-tyrosinase potentials, which might be useful for oxidative stress related diseases.

OBJECTIVE: The importance of surgico-pathologic staging in endometrial cancer to identify risk factors of the therapeutic and prognostic value has been recognized only recently. Recognition of subsets of patients should minimize treatment related morbidity and mortality for those patients with a good prognosis, while identifying patients who are at high risk for recurrence and therefore likely to benefit from adjuvant therapy. METHODS: This rettospective study was based on clinical review of 76 patients with endometrial cancer from 1983 through 1994 who underwent surgical treatment in Department of Obstettics and Gynecology at Seoul National University Hospital. All cases were restaged using the newly adopted FIGO surgical staging. Univariate and multivariate analysis were carried to compare the importance of prognostic variables. RESULTS: Significant prognostic factors in endometrial cancer were histologic subtype, depth of myometrial invasion, cervical invasion, parametrial invasion, adnexa metastasis, lymph node metastasis and peritoneal cytology(p<0.05). Age and histologic grade were not significant prognostic factors(p>0.05). Multivariate analysis showed that surgical stage and depth of myometrial invasion were important factors that predict recurrence(p<0.05). CONCLUSION: This study has yielded important information for therapeutic approach to endometrial cancer.
Endometrial Neoplasms* ; Female ; Gynecology ; Humans ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Seoul

BACKGROUND & AIMS: Management of ovarian carcinoma presents most commonly by surgery and subsequent platinum-based chemotherapy, but most patients will have either residual or recurrent disease. Taxol, a new antimicrotubule agent, has been indicated as a salvage measure after failure of first-line or subsequent chemotherapy. The purpose of this study is to investigate the efficacy and toxicity of Taxol used as a salvage therapy. MATERIALS & METHODS: Between January 1994 and Jun 1996, 19 patients aged 38-64 years(median 52) with ovarian carcinoma were given Taxol-containing regimen. Taxol was administered at a dose of 135mg/m2 intravenously with cisplatin or carboplatin every 3 weeks. The patients who treated with Taxol only were received 175mg/m2 intravenously with same interval. The median treatment cycle was 6.6 cycles(range, 3 to 15 cycles). Patient's response were evaluated with tumor marker(CA-125) and CT or MRI before and after chemotherapy. Responses and toxicities were defined according to the Gynecologic Oncology Group criteria. (continue)
Carboplatin ; Cisplatin ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Ovarian Neoplasms ; Paclitaxel* ; Salvage Therapy*

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

We report a case of Lennox-Gastaut syndrome successfully treated by the removal of hippocampal gangliocytoma. A17-year-old girl was admitted due to intractable tonic seizure, generalized tonic clonic seizure, and frequent fallingdespite the administration of polypharmacotherapy. She was mentally retarded and had developmental delays. She had the first seizure at the age of 12 months and the pattern of seizures seemed to be drop attacks. Electroencephalogram (EEG) showed background slowing of about 7 Hz, multifocal spike and wave, and generalized spike and wave complex-es (1.5~3.5 Hz). Magnetic resonance image (MRI) revealed a small polycystic mass in the left parahippocampal gyrus and hippocampal atrophy. A left hippocampectomy and total resection of the tumor was performed. Histopathologically, the cysts were identical to gangliocytoma. Sixth months later, the frequency of seizures decreased to once a month No seizures have been reported since August 1998.
Atrophy ; Electroencephalography ; Female ; Ganglioneuroma* ; Humans ; Mentally Disabled Persons ; Parahippocampal Gyrus ; Seizures ; Syncope

BACKGROUND: Primary adrenal insufficiency (PAI) is a rare, potentially life-threatening condition. There are few Korean studies on PAI, and most have had small sample sizes. We aimed to examine the etiology, clinical characteristics, treatment, and mortality of PAI in Korean patients. METHODS: A nationwide, multicenter, registry-based survey was conducted to identify adults diagnosed with or treated for PAI at 30 secondary or tertiary care institutions in Korea between 2000 and 2014. RESULTS: A total of 269 patients with PAI were identified. The prevalence of PAI was 4.17 per million. The estimated incidence was 0.45 per million per year. The mean age at diagnosis was 49.0 years, and PAI was more prevalent in men. Adrenal tuberculosis was the most common cause of PAI in patients diagnosed before 2000; for those diagnosed thereafter, adrenal metastasis and tuberculosis were comparable leading causes. The etiology of PAI was not identified in 34.9% of cases. Of the patients receiving glucocorticoid replacement therapy, prednisolone was more frequently administered than hydrocortisone (69.4% vs. 26.5%, respectively), and only 27.1% of all patients received fludrocortisone. We observed an increased prevalence of metabolic disease and osteoporosis during the follow-up period (median, 60.2 months). The observed overall mortality and disease-specific mortality rates were 11.9% and 3.1%, respectively. CONCLUSION: The prevalence of PAI is significantly lower in Koreans than in reports from Western countries. The high frequency undetermined etiology in patients with PAI suggests the need to reveal accurate etiology of PAI in Korea.
Addison Disease* ; Adult ; Autoimmune Diseases ; Diagnosis ; Fludrocortisone ; Follow-Up Studies ; Glucocorticoids ; Humans ; Hydrocortisone ; Incidence ; Korea* ; Male ; Metabolic Diseases ; Mortality ; Neoplasm Metastasis ; Osteoporosis ; Prednisolone ; Prevalence ; Sample Size ; Tertiary Healthcare ; Tuberculosis

PURPOSE: This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy in early breast cancer. MATERIALS AND MEHTODS: We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. In the BCT group, all patients received whole breast irradiation to a total dose of 45~50 Gy/5~6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1%) patients in BCT and 40 (45.5%) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19~111 months). Log rank test was used to estimate the prognostic factors for treatment failure. RESULTS: Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5%) in the mastectomy group and 10 patients (11.8%) in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT. Five patients failed at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of 5 BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2nd primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade in the mastectomy group were risk factors for treatment failure (p<0.05). CONCLUSION: Although further careful follow-up is necessary to confirm the trends evident in this series, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mastectomy* ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Risk Factors ; Survival Rate* ; Treatment Failure