BACKGROUND: An entry of needle into the epidural space has been identified by the development of negative pressure to the advancing needle; hanging drop, loss of resistance, or use of Macintosh balloon. But it is suspicious that epidural space is a true negative pressure space. METHODS: We measured the epidural pressures of pregnant patients in right lateral decubitus (RLD) and sitting position and compared with the values of non-pregnant patients of respective position. 17G Tuohy needle with closed system was used, the pressure of which was zeroed to the puncture level at third lumbar intervertebral space. RESULTS: Epidural pressures were positive in all subjects. Values of measurement were 13+/-4mmHg, 15+/-7mmHg, 16+/-6mmHg and 25+/-7mmHg for pregnant-RLD, pregnant-sitting, non-pregnant-RLD, and non-pregnant-sitting group, respectively. CONCLUSIONS: There was a significant difference between RLD and sitting position in non-pregnant patient only (p<0.05). It is suggested that the hydrostatic pressure of CSF above puncture level and the hydrostatic pressure of valveless epidural venous plexus blood influenced the epidural pressure of non-pregnant group in sitting position. But in pregnant group, abdominal mass may have elicited a draining effect on epidural venous plexus during lumbar flexion in sitting position and partially nullified the hydrostatic pressure of CSF and blood.
Epidural Space ; Humans ; Hydrostatic Pressure ; Needles ; Pregnancy ; Punctures

The Shikani Optical Stylet(TM) (SOS, Clarus Medical, USA) is another tool to facilitate tracheal intubation. It combines the benefits of a lightwand and a fiberoptic bronchoscope. We report the application of SOS in facilitating the tracheal intubation of two-person with history of difficult airway management. A 25-year-old woman with micrognathia was scheduled to undergo an exploratory laparotomy. Intubation attemps failed with a direct laryngoscope because of difficulty in her mouth opening. Although airway management was re-attempted by a laryngeal mask airway, it also failed for the same reason. Airway management was successfully performed using the SOS instead of a laryngeal mask airway. The second case was a 38-year-old woman with ankylosing spondylitis, scheduled for spinal fusion. She had difficulty in extending her neck. Intubation was successfully performed via the SOS. We believe that intubation by the SOS is a useful and readily available alternative technique for patients with difficult airways.
Adult ; Airway Management ; Bronchoscopes ; Female ; Humans ; Intubation ; Laparotomy ; Laryngeal Masks ; Laryngoscopes ; Mouth ; Neck ; Spinal Fusion ; Spondylitis, Ankylosing

PURPOSE: Recently, incidences of chronic cough with allergic disease have been increased. The identification of specific allergens for chronically coughing children is significant for diagnosis, proper treatment and prevention. The aim of this study was to identify significant contributors for sensitization in chronically coughing children. METHODS: A total of 106 children, aged 1-6 years, visiting for chronic cough(>3 weeks), were tested for inhalant multiple allergosorbent assay(MAST), eosinophil count and total IgE. Parents completed a questionnaire on past history of atopy(infantile eczema) and bronchiolitis, family history of allergy, breastfeeding, smoking, pets and floor coverings at home. RESULTS: Significant contributors for sensitization were:age(4-6 years), infantile eczema, positive family history of allergy and smoking by family. CONCLUSION: We were able to identify significant contributors for sensitization in chronically coughing children.
Allergens ; Breast Feeding ; Bronchiolitis ; Child* ; Cough* ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Incidence ; Parents ; Surveys and Questionnaires ; Smoke ; Smoking

PURPOSE: This study was to analyse the factors affecting youth smoking, especially self-efficacy and perceived social norm, based on the stage of change. METHODS: A self-reported survey was conducted during the period from the 21st of April to the 17th of May, 2008. Data were collected from 10,707 students of 12 middle schools in Seoul, Gyeonggi-do, and Incheon. The data were analysed with SPSS/WIN 15.0. RESULT: The smoking possibility was 2.18 times higher in the male students than in female students, and 1.76 times higher in 8th-grade students and 2.48 times higher in 9th-grade students than in 7th-grade ones. Smoking possibility increased when students had more experience in alcohol, more friends who smoke, or worse relationship with their parents. Also this study showed that high-level self-efficacy and perceived social norm were acting as inhibiting factors of smoking. CONCLUSION: To reduce the youth's smoking rate, smoking prevention programs should provide educational chances to learn knowledge and skills on how to reject smoking temptation. Also, someone significant like parents should make it clear to the youth that they do not want their children to smoke.
Adolescent* ; Child ; Female ; Friends ; Gyeonggi-do ; Humans ; Incheon ; Male ; Parents ; Seoul ; Smoke* ; Smoking*

OBJECTIVE: It is important to identify and treat ADHD children early to prevent secondary academial and emotional problem. The Purpose of this study is to investigate the reliability and validity of Korean parent and teacher ADHD Rating Scale. METHOD: First to sixth graders in two elementary schools in Anyang City participated in this study. Teachers and parents completed ADHD Rating Scale. Additionally parents completed K-CBCL and Conners scale. Descriptive statistics, correlation, t-test and analysis of variance were performed. RESULT: A total of 1044 students participated in this study. Correlation of rater reliabilities between parent and teacher was significantly close. And Internal consistency by age was high. As correlations among ARS, K-CBCL, Conners scale were high, the ARS scores can be validated. CONCLUSION: Korean parent and teacher ADHD Rating Scale has high reliability and validity. This scale will be a useful tool for ADHD evaluations and diagnosis. A study of comparing clinical groups is suggested.
Child ; Diagnosis ; Gyeonggi-do ; Humans ; Parents* ; Reproducibility of Results*

Intracranial lipomas are rare lesions, which represent 0.1-1.7% of all intracranial tumors. They preferentially occur near the midline, most frequently in the pericallosal cistern, and are often associated with various neurologic and systemic anomalies. Magnetic resonance imaging and computerized tomography together with clinical trials are of crucial importance for diagnosis. We report a rare case of intracranial lipoma of the body of corpus callosum in a child, who has had cyclic headache, vertigo, with a review of the literature.
Child ; Corpus Callosum ; Diagnosis ; Headache ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Vertigo

No abstract available.
Esophageal Perforation*

OBJECTIVE: To investigate the effect of peripheral nerve stretching on motor evoked potentials (MEP) as a method of facilitation. METHODS: Twenty three normal healthy volunteers were enrolled. Transcranial magnetic stimu lation (TMS) was applied to the contralateral scalp at 7 cm lateral to Cz using 90 cm round coil. Intensity of stimulation was adjusted to 90% of maximal stimulation intensity. Recording was done on the abductor pollicis brevis muscle in three different conditions; firstly resting state, secondly voluntary contraction of abductor pollicis brevis muscle, and lastly with stretching of median nerve. The onset latency and amplitude were obtained and compared between three conditions. RESULT: The amplitude of MEP was significantly increased in the condition with muscle contraction and peripheal nerve stretching compared with resting state. The latency was shortened in the condition with muscle contraction with statistical significance and with peripheral nerve stretching without significance. CONCLUSION: We concluded that stretching of peripheral nerve can be used as a method of facilitation of MEP. This method is considered to be useful especially for the patients with motor paralysis or poor cooperarion for voluntary contraction.
Evoked Potentials, Motor* ; Healthy Volunteers ; Humans ; Median Nerve ; Muscle Contraction ; Nerve Expansion ; Paralysis ; Peripheral Nerves* ; Scalp ; Transcranial Magnetic Stimulation

Background: Smartphone usage is indispensably beneficial to people’s everyday lives. However, excessive smartphone usage has been associated with physical and mental health problems. This study aimed to evaluate the association of smartphone usage with depressive symptoms, suicidal thoughts, and suicide attempts in Korean adolescents. Methods: This cross-sectional study was conducted in 54,603 Korean adolescent participants (26,930 male and 27,673 female) in the Korea Youth Risk Behavior Survey in 2017 who reported their smartphone use. We performed multiple logistic regression analysis to evaluate the association of smartphone use with mental health after adjusting for relevant covariates. Results: Among the participants, 25.6% of male students and 38.4% of female students reported using their smartphone for at least 30 hours per week. As time duration of smartphone usage increased, the risk of experiencing depressive symptoms, suicidal thoughts, and suicide attempt tended to increase, with odds ratios (95% confidence interval) of 1.18 (1.10–1.26), 1.18 (1.08–1.29), and 1.34 (1.11–1.60), respectively, for high smartphone usage compared with low smartphone usage. These associations remained significant with only slight change in odds ratios after consideration of problems that may be caused by smartphone usage, such as conflicts with family members or peers, or disturbance in school work. Conclusion Smartphone overuse was independently associated with an increased risk of mental health problems, which did not seem to be mediated by the problems caused by smartphone usage.

An 86-year-old female with a history of right rotator cuff injury was admitted for arthroscopic shoulder surgery under general anesthesia. There were no remarkable immediate postoperative complications. However, while recovering in the general ward, she developed dyspnea with hypoxia. She was immediately treated with oxygen, and antibiotics after pneumomediastinum was confirmed on both chest x-ray and chest computed tomography. Subcutaneous emphysema on either face or neck followed by arthroscopic shoulder surgery was common, but pneumomediastinum with hypoxia is a rare but extremely dangerous complication. Thus we would like to report our case and its pathology, the diagnosis, the treatment and prevention, with literature review.
Anesthesia, General ; Anoxia ; Anti-Bacterial Agents ; Arthroscopy ; Dyspnea ; Female ; Humans ; Mediastinal Emphysema ; Neck ; Oxygen ; Patients' Rooms ; Postoperative Complications ; Rotator Cuff ; Shoulder ; Subcutaneous Emphysema ; Thorax