BACKGROUNDS: Various methods have been devised for choosing the correct internal diameter (ID) of endotracheal tubes and the proper lengths for oral endotracheal tubes at different ages in children. This study was performed to evaluate the appropriate sizes of uncuffed endotracheal tubes and distance from upper incisor to carina in Korean children under 8 years old. METHODS: Five hundred thirty five children under 8 years in ASA class 1 and 2 were evaluated for the study by age groups: 0~3 months, 4~11 months and every each year until 8 years. Appropriate sizes were to permit a gas leak at 15~25 cmH2O with positive pressure ventilation. Distances from incisor to carina were at the point which bilateral lung sounds were noticed during slow extubation from endobroncheal intubation. RESULTS: Appropriate tube sizes were 3.0 mm to 3.5 mm for infants under 3 months, 3.5 mm to 4.0 mm for 4 to 11 months and ""4.15+0.28xage (yr) (mm)"" (R2=0.77, p<0.05) for children between 1 and 8 years old. Distances from upper incisor to carina were 12.0 cm for infants under 3 months, 13.7 cm for 4 to 11 months and ""14.5+0.6xage (yr) (cm)"" (R2=0.62, p<0.05) for children between 1 and 8 years old. CONCLUSIONS: We conclude that the endotracheal tube ID for the Korean children are a little greater than those of previous reports in foreign countries and airway lengths for the Korean children are similar to those of foreigners.
Child* ; Emigrants and Immigrants ; Humans ; Incisor* ; Infant ; Intubation ; Positive-Pressure Respiration ; Respiratory Sounds

OBJECTIVE: The purpose of this study was to assess the patterns of medical care utilization and factors which determine medical care utilization of elementary school children after the implementation of medical reform. METHODS: We performed the questionnaires on 1,031 children from two elementary schools in Gwangju city from June 1 to 30 June, 2001. These data were compared with data from a previous study in 1988 to evaluate the changes in medical care utilization after the implementation of medical reform. RESULTS: The prevalence rate of illness was 52.2%. The rate of persons who received medical treatment when they were sick, was 53.6%. The reasons for not treating illness were mild symptoms (84.7%), no time and too busy(4.3%), and economic causes(9.3%). The selection distribution among various medical facilities was pediatric hospital(47.2%), otolaryngologic hospital(25.8%), internal medicine(11.2%), family medicine(4.9%) and pharmacy(4.6%). The most frequently utilized medical facility for respiratory and gastrointestinal symptoms was a pediatric hospital. The major factors influencing the selection of a medical facility were geographic accessibility and good results. The most common reason for the first visit to pediatric hospital, otolaryngologic hospital or internal medicine department was geographic accessibility. CONCLUSION: Compared with a previous study in 1998, this data showed a decreased treatment rate in spite of an increased prevalence rate. The useage of pharmacies markedly decreased but visits to pediatric hospitals did not increase.
Child ; Male ; Female ; Humans

PURPOSE: The aim of this study was to evaluate the behavioral and affective characteristics of children who thought they were short. METHODS: Fifteen hundred and twenty-two students of four elementary and middle schools in Gwangju City completed a battery of questionnaires asking about stature-related stress, self-esteem, and personality characteristics. The children were divided into three groups and compared according to their answers: group I(who thought they were short, n=466), group II(who thought their heights were normal, n=802), and group III(who thought they were tall, n=254). The degree of depression was calculated using Korean Kovasc's Children's Depression Inventory. RESULTS: Four hundred and sixty-six children(30%) thought they were short. Thirty-two percent of children in group I thought that they were short although their heights were above 50 percentile. Only two percent of children that thought themselves to be short answered that they compared their height with the standard value. Twenty-seven percent of children were not satisfied with their height. No statistically significant difference of depression score was found between males and females. There were statistically significant differences of the depression score according to age(P< 0.05). The average depression scores of the three groups were 15.7+/-6.4, 13.6+/-6.8, and 12.6+/-6.3 respectively(P<0.05). In group I, no significant differences were found in depression score between the subgroups classified according to the standard height distribution. The depression score in the group of those dissatisfied with their height was significantly high(P<0.05). CONCLUSION: Correct perceptions of their height are needed for children's psychiatric healthcare. Continuous medical and psychological guidance is therefore recommended.
Child* ; Delivery of Health Care ; Depression ; Female ; Gwangju ; Humans ; Male ; Surveys and Questionnaires

Mantle cell lymphoma is relatively rare and generally difficult to differentiate from other types of lymphoma. The clinical course is very aggressive. We recently experienced a very rare patient with pleural mantle cell lymphoma associated with pleural tuberculosis. A 60-year-old female patient was admitted because of dyspnea. Chest films revealed pleural effusion. Analysis of pleural effusion was not diagnostic, but we started therapeutic trial for tuberculosis. After 2 months of anti-tuberculosis medication, the pleural effusion was not improved. We repeated pleural biopsy. Histologic finding was chronic inflammation but AFB culture was positive. After another 3 months of medications for tuberculosis, there was no improvement. We repeated pleural biopsy and thoracentesis. Repeated biopsy and the result of flow cytometry of pleural effusion were consistent with mantle cell lymphoma. We started chemotherapy for lymphoma. After three cycles of chemotherapy, pleural effusion was decreased, but she worsened and died of hepatic failure probably due to viral hepatitis.
Biopsy ; Drug Therapy ; Dyspnea ; Female ; Flow Cytometry ; Hepatitis ; Humans ; Inflammation ; Liver Failure ; Lymphoma ; Lymphoma, Mantle-Cell* ; Middle Aged ; Pleural Effusion ; Pleurisy ; Thorax ; Tuberculosis ; Tuberculosis, Pleural*

Fetal umbilical blood was obtained by cordocentesis guided by transabdominal USG in 276 fetuses at more than 14 weeks gestation. Fetal daryotyping was carried out in 7 cases of cordocentesis-failed group by cardiocentesis (3 cases) and amniocntesis (4 cases). The 46 cases in 263 fetuses revealed abnormal karyotypes (17.5%). There were 24 cases of numerical abnormality, 14 cases of structural abnormality, 5 cases of mosaicism, and 3 miscellaneous abnormalities. In the numerical abnormalities, trisomies and sex chromosomal abnormalities were 22 and 2 case, respectively. In 22 trisomy cases, there were 16 cases of trisomy of 18 chromosome which is the most common single cytogenetic abnormality in cordocentesis. The most common associated anomalies in trisomy 18 was congenital heart anomaly, in which vetricular septal defect was the most common. Pregnancy outcome is as follows: 22 cases of termination of pregnancy, 9 cases of still-birth, 5 cases of neonatal death, three living babies and 7 cases lost to follow-up.
Abnormal Karyotype ; Chromosome Aberrations ; Cordocentesis* ; Female ; Fetus ; Heart ; Humans ; Karyotyping* ; Lost to Follow-Up ; Mosaicism ; Pregnancy ; Pregnancy Outcome ; Trisomy

BACKGROUND: Enhancement and maintenance of the stemness of mesenchymal stem cells (MSCs) is one of the most important factors contributing to the successful in vivo therapeutic application of these cells. In this regard, three-dimensional (3D) spheroid formation has been developed as reliable method for increasing the pluripotency of MSCs. Moreover, using a new protocol, we have previously shown that dental tissues of extracted wisdom teeth can be effectively cryopreserved for subsequent use as a source of autologous stem cells. The main purpose of this study is to analyze the stemness and in vitro osteogenic differentiation potential of 3D spheroid dental MSCs compared with conventional monolayer cultured MSCs. METHODS: In this study, MSC-characterized stem cells were isolated and cultured from long-term cryopreserved dental follicles (hDFSCs), and then 2D hDFSCs were cultured under 3D spheroid-forming conditions using a newly designed microchip dish. The spheroids (3D hDFSCs) thus produced were investigated and characterized with respect to stemness, MSC marker expression, apoptosis, cell cycle analysis, extracellular matrix (ECM) production, and osteogenic and adipogenic differentiation properties. RESULTS: In terms of MSC and senescence markers, spheroid cells showed no difference when compared with 2D hDFSCs; however, 3D hDFSCs were observed to have a higher proportion of cell cycle arrest and a larger number of apoptotic cells. Moreover, spheroids showed substantially increased levels of pluripotency marker (early transcription factors) and ECM protein expression. Compared with 2D hDFSCs, there was also a notable enhancement in the osteogenic induction potential of spheroids, although no differences were observed with respect to in vitro adipogenesis. CONCLUSION: To the best of our knowledge, this is the first study to demonstrate the application of a spheroid culture system for dental follicle-derived stem cells using a microchip dish. Although further studies are needed, including in vivo transplantation, the results obtained in this study indicate that spheroid hDFSCs derived from cryopreserved dental follicle tissues could be used as a valuable source of autologous stem cells for bone tissue regeneration.
Adipogenesis ; Aging ; Apoptosis ; Bone and Bones ; Cell Cycle ; Cell Cycle Checkpoints ; Dental Sac ; Extracellular Matrix ; Humans ; In Vitro Techniques ; Mesenchymal Stromal Cells ; Methods ; Molar, Third ; Osteogenesis ; Regeneration ; Stem Cells

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat accumulation in the liver. MASLD encompasses both steatosis and MASH. Since MASH can lead to cirrhosis and liver cancer, steatosis and MASH must be distinguished during patient treatment. Here, we investigate the genomes, epigenomes, and transcriptomes of MASLD patients to identify signature gene set for more accurate tracking of MASLD progression. Methods: Biopsy-tissue and blood samples from patients with 134 MASLD, comprising 60 steatosis and 74 MASH patients were performed omics analysis. SVM learning algorithm were used to calculate most predictive features. Linear regression was applied to find signature gene set that distinguish the stage of MASLD and to validate their application into independent cohort of MASLD. Results: After performing WGS, WES, WGBS, and total RNA-seq on 134 biopsy samples from confirmed MASLD patients, we provided 1,955 MASLD-associated features, out of 3,176 somatic variant callings, 58 DMRs, and 1,393 DEGs that track MASLD progression. Then, we used a SVM learning algorithm to analyze the data and select the most predictive features. Using linear regression, we identified a signature gene set capable of differentiating the various stages of MASLD and verified it in different independent cohorts of MASLD and a liver cancer cohort. Conclusions We identified a signature gene set (i.e., CAPG, HYAL3, WIPI1, TREM2, SPP1, and RNASE6) with strong potential as a panel of diagnostic genes of MASLD-associated disease.