BACKGROUND: This study was conducted to explore the prevalence of and the factors affecting constipation in elementary school students in urban and rural areas. METHODS: Study subjects were 585 grade 5 and 6 students. We conducted self-administered questionnaires during October, 2009. Outcome measure was the prevalence of constipation evaluated by the Rome III Diagnostic criteria for functional constipation. Independent variables were gender, grade, residence, mother's employment status, self-rated health status, number of family members, bowel movement habit, and health behavior (nutrition, exercise, and stress). RESULTS: The multiple logistic regression analysis showed that females, grade 5 students, those with working mothers, and those physically inactive reported having constipation significantly more often. CONCLUSIONS: Our study revealed that the female gender, increasing age, mother's employment status, and physical inactivity were risk factors for constipation in elementary school students. To improve bowel function in children, health education programs and school health promotion programs targeting healthy life habits should be implemented.
Child ; Constipation* ; Employment ; Female ; Health Behavior ; Health Education ; Humans ; Logistic Models ; Mothers ; Outcome Assessment (Health Care) ; Prevalence* ; Risk Factors ; School Health Services ; Surveys and Questionnaires

No abstract available.
Neurilemmoma*

No abstract available.
Abscess* ; Magnetic Resonance Imaging*

No abstract available.
Chordoma*

Posterior lumbar interbody fusion can simultaneously achieve spinal stabilization, anterior-column support, and direct neural decompression via a posterior approach. Unilateral transforaminal lumbar interbody fusion (TLIF) has several advantages such as less invasive and less retraction of neural components compared with conventional interbody fusion. But standard posterior spinal fusion with instrumentation requires a moderate amount of paraspinal musculoligamentous dissection. This dissection causes muscle denervation and atrophy that increases risk for failed back syndrome. Therefore, the authors performed a minimally invasive unilateral TLIF with a tubular retractor system combined with pedicle screw fixation to minimize the iatrogenic tissue injury. Although a less invasive unilateral approach was used, the early and longterm outcomes were as good as those on many reported series of posterior interbody fusion. More comfortness during the early postoperative period, small operation scar and less blood loss were the beneficial points compared with other conventional procedures. In the cases of instability of one-motion segment, pedicle screw fixation and TLIF with the tubular retractor system, minimally invasively, can reduce unnecessary trauma to the lumbar supporting structures while still accomplishing sufficient decompression and effective stabilization.
Atrophy ; Cicatrix ; Decompression ; Muscle Denervation ; Postoperative Period ; Spinal Fusion

We present a case with seizure, confusion, hypesthesia and paraplegia after intrathecal injection of fluorescein. A 41-year-old man was admitted to our institution for the management of the CSF leakage. Intrathecal injection of fluorescein was performed and he complained of severe pain and numbness in the lower extremities at the end of the injection. Four hours later, he exhibited confusion, paraparesis and two episodes of generalized seizures. Two days later, he showed paraplegia and all sensory modalities below the T12 level were absent. Spine magnetic resonance imaging revealed myelopathic change in the lower thoracic spinal cord. There was no improvement of weakness and sensory deficits in lower extremity even 14 days after fluorescein injection. We speculated that thoracic myelopathy was associated with the intrathecal injection of fluorescein. In spite of its rarity, the complication after intrathecal injection of fluorescein could be serious. Thus, obtaining an informed consent with discussion with patient before the procedure is mandatory.
Adult ; Fluorescein* ; Humans ; Hypesthesia ; Informed Consent ; Injections, Spinal* ; Lower Extremity ; Magnetic Resonance Imaging ; Paraparesis ; Paraplegia ; Seizures ; Spinal Cord ; Spinal Cord Diseases* ; Spine

BACKGROUND: High dose fentanyl for cardiac surgery in neonates, infants and children can cause severe bradycardia and chest wall rigidity that result in decreased cardiac output and oxygen desaturation due to fixed stroke volume in pediatric patients. To ameliorate the effects of fentanyl, it is common to administer neuromuscular blocking drugs with wanted cardiovascular side effects. This study was designed to compare the cardiovascular variables and oxygen saturation among different muscular relaxants in high dose fentanyl anesthesia. METHODS: Thirty pediatric cardiac patients were allocated randomly into three muscle relaxant groups treated with 0.2 mg/kg pancuronium (n=10), 0.2 mg/kg vecuronium (n=10) or 0.2 mg/kg pipecuronium (n=10) after receiving an initial bolus dose of 25 g/kg of fentanyl. Changes of heart rate (HR), mean arterial blood pressure (MAP), rate-pressure-product (RPP) and oxygen saturation (SpO2) were observed. The same cardiovascular variables were also observed 1 and 2 minutes after the second bolus dose of 25 g/kg fentanyl and compared to the results among muscle relaxants. RESULTS: HR, MAP and RPP decreased significantly (p<0.05) 1 and 2 minutes after injection of the 1st fentanyl, which returned to levels above the control value after administration of pancuronium, vecuronium or pipecuronium. Among muscle relaxants, pancuronium caused the most rapid and significantly high level compared to the control value in HR and MAP. Next was pipecuronium and then vecuronium. In clinical setting, SpO2 was decreased after the 1st fentanyl injection and increased after the injection of muscle relaxants, but not significant statistically. CONCLUSION: In view of hemodynamic changes, pancuronium is most efficient and rapid in returning the hemodynamic variables that was decreased after high dose fentanyl anesthesia in neonates, infants and children whose cardiac output was dependent on HR due to relatively fixed stroke volume.
Anesthesia* ; Arterial Pressure ; Bradycardia ; Cardiac Output ; Child* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Infant* ; Infant, Newborn* ; Neuromuscular Blockade ; Oxygen ; Pancuronium* ; Pipecuronium* ; Stroke Volume ; Thoracic Surgery ; Thoracic Wall ; Vecuronium Bromide*

No abstract available.
Glioma*

A 18-year-old girl, who presented with painful scalp mass on occipital region, was found in have a congential dermal sinus. At surgery, upon incision of the occipital muscle fascia, pus poket was encountered and it was connected with thickened occipito-cervical dura through the small foramen on midline occiptial bone. The pathogenesis and principles of management are briefly reviewed.
Adolescent ; Dermoid Cyst* ; Fascia ; Female ; Humans ; Scalp ; Spina Bifida Occulta ; Suppuration

OBJECTIVE: Although the L5-S1 has distinct structural features in comparison with other lumbar spine segments, not much is known about adjacent segment degeneration (ASD) at the L5-S1 segment. The aim of study was to compare the incidence and character of ASD of the cephalad and L5-S1 segments after L5 floating lumbar fusion. METHODS: From 2005 to 2010, 115 patients who underwent L5 floating lumber fusion were investigated. The mean follow-up period was 46.1 months. The incidence of radiological and clinical ASD of the cephalad and the L5-S1 segments was compared using survival analysis. Risk factors affecting ASD were analyzed using a log rank test and the Cox proportional hazard model. RESULTS: Radiological ASD of the L5-S1 segment had a statistically significant higher survival rate than that of the cephalad segment (p=0.001). However, clinical ASD of the L5-S1 segment was significantly lower survival rates than that of the cephalad segment (p=0.038). Risk factor analysis showed that disc degeneration of the cephalad segment and preoperative spinal stenosis of the L5-S1 segment were risk factors. CONCLUSION: In L5 floating fusion, radiological ASD was more common in the cephalad segment and clinical ASD was more common in the L5-S1 segment. At the L5-S1 segment, the degree of spinal stenosis appears to be the most influential risk factor in ASD incidences, unlike the cephalad segment.
Follow-Up Studies* ; Humans ; Incidence ; Intervertebral Disc Degeneration ; Proportional Hazards Models ; Risk Factors* ; Spinal Stenosis ; Spine ; Survival Rate*