No abstract available.
Hepatolenticular Degeneration*

Segmental dilatation of small intestine or colon can induce signs of intestinal obstruction, such as abdominal distension, vomiting and constipation. There are no anatomical gross obstructive lesions, and moreover, ganglion cells are observed in both dilated and undilated distal segments of the intestine. It often accompanied by other congenital anomalies. We reported two cases of segmental dilatation of the intestine in the newborn infants, one in small intestine and the other in colon, with brief review of the related literatures.
Colon ; Constipation ; Dilatation* ; Ganglion Cysts ; Humans ; Infant, Newborn* ; Intestinal Obstruction ; Intestine, Small ; Intestines* ; Vomiting

A case of Peutz-Zeghers syndrome in a year and 8 month old girl was Presented. Her chief complaints were abdominal pain, vomiting and melanin pigmemtation on the lips and perioral area. On family history, her mother and elder sister suffered from same symptom. Physical examination showed melanin pigentation on the lips and perioral area, and markedly distended abdomen. Abdominal simple X-ray film showed fluid level, and so diagnosed as small bowel obstruction. Operation performed at 2nd admission day, and those findings were intusussusception of jejunojejunal type and multiple polyps. The diagnosis was confirmed by family history, characterisic pogmentation and multiple small intestinal polyps of jejunum. Brief review of related literatures were also presented.
Abdomen ; Abdominal Pain ; Diagnosis ; Female ; Humans ; Infant ; Intestinal Polyps ; Jejunum ; Lip ; Melanins ; Mothers ; Physical Examination ; Polyps ; Siblings ; Vomiting ; X-Ray Film

PURPOSE: Spirometry, because of its simplicity and reproducibility, has been used to evaluate pulmonary function in childhood asthma. We investigated whether FEF25-75% is the most sensitive parameter among other spirometric parameters in the diagnosis of pulmonary function and airway obstruction. METHODS: This study included 32 children with asthma. We recorded values of spirometry(FVC, FEV1, PEFR, and FEF25-75%) before and after symptomatic improvement and compared them. The values were recorded as a percent of the predicted normal value. RESULTS: The FEV1 value before and after symptomatic improvement was 71.7+/-15.6% and 83.8+/-12.8%, respectively; PEFR was 75.4+/-18.3% and 85.0+/-16.0%; and FEF25-75% was 60.8+/-17.9% and 81.5+/-16.3%. According to symptomatic improvement, FEF25-75% improved more than the other spirometric parameters. Of the 40 cases of spitometric measurement before symptomatic improvement, abnormal FEV1, PEFR, FEF25-75% values were observed in 25, 17 and 28 cases, respectively. There was statistically significant difference between FEF25-75% and PEFR(P=0.005), but not between FEF25-75% and FEV1(P=0.091). After symptomatic improvement, abnormal FEV1, PEFR, and FEF25-75% values were observed in 14, 12 and 9 cases, respectively. There was statistically significant difference between FEF25-75% and FEV1(P=0.044) but not between FEF25-75% and PEFR (P=0.097). The cases of normalized values with symptomatic improvement, 11 in FEV1, 7 in PEFR and 19 in FEF25-75%. CONCLUSION: FEF25-75% showed the most improvement rate before and after symptomatic improvement. FEF25-75% was helpful in the assessment of treatment effectiveness and reversible bronchial responsiveness. However, this study did not suggest that FEF25-75% is the most sensitive measurement of airway obstruction.
Airway Obstruction ; Asthma* ; Child ; Diagnosis ; Humans ; Peak Expiratory Flow Rate ; Reference Values ; Spirometry ; Treatment Outcome

Hypothyroidism can cause a variety of signs and symptoms of the neuromuscular system. However, ptosis in a patient with hypothyroidism is very rare. We report here on a case of central hypothyroidism that was due to Sheehan's syndrome and it manifested as bilateral ptosis in a 51-yr-old woman. She complained of exertional dyspnea and weakness. About 25-yr ago, she had a history of severe postpartum vaginal bleeding. The laboratory studies demonstrated hypopituitarism with secondary hypothyroidism. The ptosis was improved by replacement of thyroid hormone. Hypothyroidism should be considered in the differential diagnosis of patients who manifest with ptosis and that prompt replacement of hormone can lead to a complete recovery.
Blepharoptosis/complications/*diagnosis/drug therapy ; Electromyography ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/complications ; Magnetic Resonance Imaging ; Middle Aged ; Muscular Diseases/etiology ; Neuromuscular Junction/physiopathology ; Prednisolone/therapeutic use ; Thyroxine/therapeutic use

PURPOSE: Brain surface intensity model (BSIM)-based cortical thickness analysis does not require complicated 3D segmentation of brain gray/white matters. Instead, this technique uses the local intensity profile to compute cortical thickness. The aim of the present study was to evaluate intra-rater and inter-rater reliability of BSIM-based cortical thickness analysis using images from elderly participants. MATERIALS AND METHODS: Fifteen healthy elderly participants (ages, 55-84 years) were included in this study. High-resolution 3D T1-spoiled gradient recalled-echo (SPGR) images were obtained using 3T MRI. BSIM-based processing steps included an inhomogeneity correction, intensity normalization, skull stripping, atlas registration, extraction of intensity profiles, and calculation of cortical thickness. Processing steps were automatic, with the exception of semiautomatic skull stripping. Individual cortical thicknesses were compared to a database indicating mean cortical thickness of healthy adults, in order to produce Z-score thinning maps. Intra-class correlation coefficients (ICCs) were calculated in order to evaluate inter-rater and intra-rater reliabilities. RESULTS: ICCs for intra-rater reliability were excellent, ranging from 0.751-0.940 in brain regions except the right occipital, left anterior cingulate, and left and right cerebellum (ICCs = 0.65-0.741). Although ICCs for inter-rater reliability were fair to excellent in most regions, poor inter-rater correlations were observed for the cingulate and occipital regions. Processing time, including manual skull stripping, was 17.07 +/- 3.43 min. Z-score maps for all participants indicated that cortical thicknesses were not significantly different from those in the comparison databases of healthy adults. CONCLUSION: BSIM-based cortical thickness measurements provide acceptable intra-rater and inter-rater reliability. We therefore suggest BSIM-based cortical thickness analysis as an adjunct clinical tool to detect cortical atrophy.
Adult ; Aged ; Atrophy ; Brain* ; Cerebellum ; Humans ; Magnetic Resonance Imaging* ; Skull

The purpose of this study was to develop an education program for hospice care and to examine the effect of program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with witch terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description after the performance of education. put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.
Chungcheongbuk-do ; Education* ; Hospice Care* ; Hospices* ; Humans ; Lectures ; Missions and Missionaries ; Philosophy

A study on physically and mentally handicaped children was carried out by health commttee of korean pediatric Association on August, 1977. 654 children in 5 special children's Institutes in Seoul area were observed and the results obtained were as follows ; 1. 393 out of 654 cases were males and male to female ratio was 6 : 4. The most Common age group in institutes were over 10 years (45.6%). As the age goes young, the number of cases were decreased. 2. 43.7% of all cases were orphans. 3. The most common handicap was cerebral palsy(33.3%). Poliomyelitis(24.0%) and mental retardation (20.0%) were the next and these 3 handicaps were ranged 78.1% of all handicaps. The other less common handicaps were Cong. Anomaly(8.1%), mongolism(4.3%) Tb spine or hip joint(2.1%) and microcephaly(2.0%) in order of frequency. 4. Handicaps originated from acquired and congenital were 37.5% and 15.9% respectively. But the remains were obscure in origin. Cong. Anomaly, mongolism and microcephaly were common causes of congenital origin and poliomyelitis, cerebral palsy and Tb hip or spine were frequently acquired. 5. Only 64 cases(18.0%) of cerebral palsy and mental retardation had Known Causes. These were caused by birth injury(24cases), prematurity, Kern icterus or meningigis. 6. 65.4% of all cases had mentally retardation. 87.2% of cerebral palsy nd 83.0% of congenital anomaly were mentally retarded and all cases with mongolism, microcephaly, hydrocephalus and spina bifida mental retardation. 7. The most common site of congenital anomaly was extremities or joints(47.1%) and multiple anomalies were 28.5% of all anomalies. 8. Less than 6 months of institution were common in paid cases(24.9%) in spite of 5~10 year in institule were common in orphans (28.3%). Even in paid cases, economic stase were very low level.
Academies and Institutes ; Cerebral Palsy ; Child* ; Child, Orphaned ; Down Syndrome ; Extremities ; Female ; Hip ; Humans ; Hydrocephalus ; Intellectual Disability ; Jaundice ; Male ; Mentally Disabled Persons ; Microcephaly ; Parturition ; Poliomyelitis ; Seoul ; Spinal Dysraphism ; Spine ; Statistics as Topic*

A statistical study on visually handicapped children was performed by The Committee on Health of Korean Pediatric Association from July to October, 1978. 3,930 boys and girls in middle school children(3rd grade; around 15 years of age) were studied and the results were obtained as follows; 1, 788 out of 3,930 children(20.1%) were visually handicapped. There were no sex preponderance. 2. Annual incidence of visual handicap was 2.2% of all children studied. 3. There were no specific age preferance for handicapping and annual incidence of visual retardations among the handicapped children was 13.7%(10~19%). 4. Children wearing corrective glasses were 62.8% of all handicapped children and 69.8% of them were began to wear the glasses after entrance of middle school. 5. Nearly all of the handicapped children were suffered from symptoms related with visual defect and the most common difficulty was learning problems(67.5%). Headache(6.7%) and dizziness(5.5%) were another difficulties. 6. 92.5% of children wearing glasses were improved their symptoms related with poor visions but 79.8% of children wearing glasses were suffered form discomfortness by glasses itself. 7. The reasons wearing no glasses among the visual handicaps were advices by parents and friends due to bad effects of glasses on beauty(321.%), hesitation(30.7%) and shyness(13.3%). 8. High famillial incidence of visual handicaps were noted in visually handicapped children than with normal vision. 9. There were no difference between the children with defective vision and normal children on number of television sets at home, places of telvision set ups(children's room or parent?sroom), hours watching televison per day, presence or absence of children's study rooms and reading postures. 10. Habits of watching television or reading books from too short distance, improper illumination when they read the books at home were much more freqently observed in children with visual handicap than children with no defect.
Child ; Disabled Children* ; Disabled Persons* ; Eyeglasses ; Female ; Friends ; Glass ; Humans ; Incidence ; Learning ; Lighting ; Parents ; Posture ; Statistics as Topic* ; Television

PURPOSE: Peripheral neuropathy is the most common chronic complication of insulin- dependent diabetes mellitus, which is one of the most frequent endocrine metabolic disorders in children. However, there are very few long-term follow-up studies on the condition in publication and none in Korean literature. In order to find out the correlation between the severity of peripheral neuropathy and glycosylated hemoglobin level, an indicator of diabetes control, a follow-up study was conducted on cases of insulin- dependent diabetes mellitus. METHODS: The study was conducted on 37 patients with insulin-dependent diabetes mellitus (12 males, 25 females, aged 7-21 years) who were diagnosed and were being treated in general hospitals in the Taegu-Kyungpook area from 1994 to 1998. They were also subject to nerve conduction velocity test at least two times with an interval of one or more years. Nerve conduction velocity was measured by using type MEM-3102 apparatus of Nihon Kohden (on motor and sensory component of left ulnar nerve and median nerve, motor component of left and right peroneal, posterior tibial nerve, sensory component of left and right sural nerve) and medical history was taken, neurological examination was done and glycosylated hemoglobin levels were measured with each test. RESULTS: The total number of nerve conduction velocity tests was 89 and the results were divided into 5 groups [normal : 14 cases (15.7%); borderline: 35 cases (39.3%); mononeuropathy : 2 cases (2.2%); mild polyneuropathy : 22 cases (24.7%); severe polyneuropathy : 16 cases (18.0%)] by the number and distributions of nerves that were found abnormal. Ten of the 26 cases, belonging to the normal or borderline group in the first test, showed signs of peripheral neuropathy in later tests, and of the 11 cases with peripheral neuropathy in the first test, none improved to be included in the normal or borderline group in the follow-up study. The mean glycosylated hemoglobin level was 9.2+/-2.5% in normal group, 11.9+/-3.2% in borderline group, 13.0+/-0.3% in mononeuropathy group, 12.0+/-3.7% in mild polyneuropathy group and 14.8+/-4.0% in severe polyneuropathy group, and glycosylated hemoglobin level rose with the severity of the neuropathy (r=0.372, p< 0.01). In the 9 cases that had shown improvement of peripheral neuropathy, glycosylated hemoglobin levels decreased significantly by an average of 3.5+/-1.3% with each level of improvement (t-test, p<0.05), but in 20 cases with deteriorating nerve conduction velocity, there was no significant correlation with increase in glycosylated hemoglobin levels. CONCLUSION: Peripheral neuropathy complicating insulin-dependent diabetes mellitus can occur during diabetes treatment and does not improve easily once it occurs. In this study, the glycosylated hemoglobin level was shown to have a high degree of correlation with the occurrence and progression of neuropathy, which means that control of hyperglycemia is difficult and also that stricter control of blood glucose during early stages of diabetes is necessary to prevent neuropathy. Follow-up studies with bigger samples and longer time will be needed for a more detailed look.
Blood Glucose ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1* ; Female ; Follow-Up Studies* ; Hemoglobin A, Glycosylated ; Hospitals, General ; Humans ; Hyperglycemia ; Male ; Median Nerve ; Mononeuropathies ; Neural Conduction ; Neurologic Examination ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Publications ; Tibial Nerve ; Ulnar Nerve