OBJECTIVES: Identifying children with Attention-Deficit/Hyperactivity Disorder (ADHD) and providing early therapeutic interventions for them are important to prevent secondary problems in academic achievement and emotional disturbances. The aims of the study is to examine the characteristics of K-ARS for parents and teachers, a screening questionnaire to identify children with ADHD, by age and sex of the children, to examine its clinical validity, and to provide norm data of K-ARS for school-aged children which will facilitate the use of K-ARS in clinical practice and research. METHODS: Randomly selected 1st to 6th graders of the two elementary schools (N=1044) in Anyang City participated in this study. Twenty three children diagnosed with ADHD at the child and adolescent clinic at the Hallym University Sacred Heart Hospital were included in this study for the analysis of validity. Parents and teachers completed K-ARS. Descriptive statistics, t-test and analysis of variance were performed. RESULTS: K-ARS scores showed significant difference according to the gender, with boys having higher scores than girls. There was no significant difference of the scores by ages. Validity analysis showed that K-ARS distinguishes children with ADHD from children without ADHD well. The normative data were presented by age and sex. CONCLUSION: K-ARS for parents and teachers has an excellent clinical validity to discriminate children with ADHD from children without ADHD. Different normative data of K-ARS need to be used due to the gender difference. K-ARS is a useful tool for screening and identifying children with ADHD. Future studies are required to include larger samples with adolescents in various geographic areas.
Adolescent ; Affective Symptoms ; Child ; Female ; Gyeonggi-do ; Heart ; Humans ; Mass Screening ; Parents* ; Surveys and Questionnaires

Trichoblastoma is a rare benign neoplasm that arises in the follicular germinative cells. The terminology and histopathological definition of this tumor is both complex and confusing. Trichoblastoma occurs only on the hair bearing areas such as the scalp, face and pelvic area with varying degrees in size. We describe a case of trichoblastoma occurring as a nodule on the nose. The tumor was composed of numerous lobules of basaloid epithelial cell nests with distinct peripheral palisading of nucleoli that were clearly demarcated from the stroma.
Epithelial Cells ; Hair ; Nose ; Scalp

PURPOSE: To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. MATERIALS AND METHODS:During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive baloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. RESULTS: The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. CONCLUSION:The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma
Carcinoma, Renal Cell* ; Catheters ; Ethanol ; Humans ; Immunotherapy* ; Interferon-alpha ; Survival Rate

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

In order to evaluate contamination of the topical eye drugs, 112(36 kinds) medications used over 1 month by the patients and 80(25 kinds) medications used at OPD(outpatient department) were studied by culturing the caps, the tips and the contents. Coagulase-negative staphylococcus was mainly isolated from the caps and the tips(p<0.05). But the other gram-positive bacteria, gram-negative bacteria and fungi were isolated from all medication sites. The most frequent site of contamination was the tips of the medications. Frequency of contamination based on detail of medications and preservatives of medications was not statistically significant(p>0.05). The medications used by the patients for a long time in comparison with the medications used at OPD were significantly more likely to be contaminated(p<0.0001). Therefore, we think that the topical eye durgs should be used with proper instillation and storage for a short period because of increase risk of contamination.
Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Staphylococcus

The incidence of severe hepatitis A virus (HAV) infection has been increasing. However, clinicopathologic features of severe HAV infection that lead to liver transplantation (LT) have not been reported in Korea. We retrieved 16 LT cases with HAV infection during the last 3 years at Asan Medical Center, Seoul, Korea. Fifteen cases progressed to hepatic encephalopathy. Thirteen cases survived with or without complications, and three patients died of sepsis. The explanted liver showed massive or zonal necrosis with moderate to severe cholestasis. The zonal distribution of necrosis was frequently associated with endothelialitis of portal and/or central veins. Degenerative changes of hepatocytes were various in degree and distribution. Viral inclusions were suspected in two cases. Although HAV infection is usually confirmed by serological tests, significant venulitis of central and/or portal veins and viral inclusions, which are rarely observed, can suggest an HAV infection as a cause of massive hepatic necrosis of unknown mechanism.
Cholestasis ; Fluconazole ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A ; Hepatitis A virus ; Hepatocytes ; Humans ; Incidence ; Korea ; Liver ; Liver Transplantation ; Massive Hepatic Necrosis ; Necrosis ; Portal Vein ; Sepsis ; Serologic Tests ; Veins

Abrupt increase in the size of cervico-mediastinal tumor due to infection or spontaneous hemorrhage into cyst can induce severe tracheal compression and therefore sudden death. A 5 year old boy, who had a history of URI, had an enlarging cystic hygroma on the right side of the neck and anterior mediastinum. Under diagnosis of the cervico-mediastinal cystic hygroma, surgical removal was scheduled. After induction of anesthesia, intubation was done without any difficulty. A few minutes later, signs of partial airway obstruction were appeared. And within a very short period, total airway occlusion occurred. The tracheal tube was removed and manual ventilation was performed with positive airway pressure, but ineffective. We attempted to puncture cricothyroid membrane with 14 Gauge needle in order to ventilate manually. As soon as we puncture cricothyroid membrane, straw-colored fluid, not air, gushed out through a needle. After aspiration of about 200ml of cystic fluid, the obstructive signs disappeared and the patency of the airway was maintained. Intraoperatively, no more airway problems occured and vital signs were stable. And postoperatively, patient had no specific complications and discharged on the 7th day after operation.
Airway Obstruction* ; Anesthesia ; Child, Preschool ; Death, Sudden ; Diagnosis ; Hemorrhage ; Humans ; Intubation ; Intubation, Intratracheal* ; Lymphangioma, Cystic* ; Male ; Mediastinum ; Membranes ; Neck ; Needles ; Punctures ; Ventilation ; Vital Signs

Purpose: This study aimed to identify the effects of musculoskeletal symptoms and burden on presenteeism among nurses in a gastrointestinal endoscopy unit. Methods: This was an observational cross-sectional study. Data were collected through self-reported questionnaires administered to 140 nurses working in the gastrointestinal endoscopy unit of a hospital located in Busan metropolitan city. Results: The body part with the most musculoskeletal symptoms was the back (73.2%), and the most common musculoskeletal burden work was "when you have to stand or maintain the same posture for a long time in a lead apron protection clothes.” The factors most related to work impairment were working hours, musculoskeletal symptoms, and musculoskeletal burden, with an explanatory power of 63.3%. Factors affecting perceived productivity were working hours and musculoskeletal symptoms, with an explanatory power of 29.2 %. Conclusion To reduce work impairment and increase the perceived productivity of nurses in gastrointestinal endoscopy units, various programs and improved working environments are needed that can improve musculoskeletal symptoms and reduce musculoskeletal burden.

A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxy-genation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
Adult ; Airway Obstruction ; Anemia, Aplastic ; Barotrauma* ; Bronchoscopy ; Emergencies ; Female ; Hemoptysis* ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Subcutaneous Emphysema ; Ventilation* ; Ventilators, Mechanical

Down syndrome is the most common chromosomal disorder and is accompanied by hip osteoarthritis in approximately 28% of patients.This paper reports a case of hip arthrodesis as a treatment for severe hip osteoarthritis in adolescent Down syndrome patients. When performing surgical treatment of patients with Down syndrome, it is necessary to take a comprehensive approach that considers not only the medical point of view, but also the psychological and economic requirements of the patient and their social environment.