OBJECTIVES: The aim of this study was to examine the relationship between personality of parent and offspring, and offspring's psychological adaptation. METHODS: We examined temperament and character of 65 parents and their offspring (measured using the Junior Temperament and Character Inventory and Temperament and Character Inventory) and offspring's internalizing (anxiety, depression) and externalizing (delinquency, hyperactivity) problems. RESULTS: The internalizing problems of offspring were positively associated with harm avoidance (HA) of offspring and parent, and negatively associated with self-directedness (SD) of offspring and parent. The externalizing problems of offspring were positively associated with novelty seeking of offspring, and were predicted by SD of parent. The interaction between parent's HA and offspring's HA predicted higher levels of anxiety of offspring. CONCLUSION: The association between the offspring's personality and internalizing and externalizing problems can depend on the personality of the parent.
Adaptation, Psychological* ; Anxiety ; Humans ; Parents ; Temperament

Although the number of studies using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) for the treatment of high-risk pediatric solid tumors has been increasing, documentation of hematologic recovery after tandem HDCT/autoSCT is very limited. For this reason, we retrospectively analyzed the hematologic recovery of 236 children with high-risk solid tumors who underwent tandem HDCT/autoSCT. The median numbers of CD34+ cells transplanted during the first and second HDCT/autoSCT were 4.3 x 10(6)/kg (range 0.6-220.2) and 4.1 x 10(6)/kg (range 0.9-157.6), respectively (P = 0.664). While there was no difference in neutrophil recovery between the first and second HDCT/autoSCT, platelet and RBC recoveries were significantly delayed in the second HDCT/autoSCT (P < 0.001 and P < 0.001, respectively). Delayed recovery in the second HDCT/autoSCT was more prominent when the number of transplanted CD34+ cells was lower, especially if it was < 2 x 10(6)/kg. A lower CD34+ cell count was also associated with increased RBC transfusion requirements and a higher serum ferritin level after tandem HDCT/autoSCT. More CD34+ cells need to be transplanted during the second HDCT/autoSCT in order to achieve the same hematologic recovery as the first HDCT/autoSCT.
Adolescent ; Antigens, CD34/metabolism ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Blood Cell Count ; Blood Platelets/cytology ; Child ; Child, Preschool ; Combined Modality Therapy ; Erythrocytes/cytology ; Female ; Ferritins/blood ; Humans ; Infant ; Male ; Neoplasms/*drug therapy ; Neutrophils/cytology ; Retrospective Studies ; *Stem Cell Transplantation ; Stem Cells/cytology/metabolism ; Transplantation, Autologous ; Young Adult

PURPOSE: To evaluate the pathological and clinical effects of preoperative chemoradiation (CCRT) in cases of locally advanced rectal cancer and to determine the predictive factors for tumor downstaging. MATERIALS AND METHODS: From March 2004 to August 2008, 33 patients with locally advanced rectal cancer were treated with preoperative CCRT. Twenty-eight patients (84.8%) were treated using a concomitant boost technique while five (15.2%) patients were treated using a cone down boost technique. All patients received 50.4 Gy of irradiation and concurrent chemotherapy with 5-fluorouracil. The median follow-up duration was 24.2 months (range, 9.8 to 64.7 months). RESULTS: Thirty-one (93.9%) patients underwent surgery. Twenty-four patients (72.7%) underwent anal sphincter-preserving surgery. The 3-year disease free survival (DFS) and overall survival rates were 63.4% and 78.8%, respectively. Post-operative factors were more important for DFS. Pathologic N stage, margin status, and pathologic differentiation were significant prognostic factors (p=0.001, 0.029, 0.030). Tumor size and lymphovascular invasion were also associated with marginal significance (p=0.081, 0.073). However, only pre-treatment T stage was a significant pre-operative factor (p=0.018). The complete pathological response rate was 9.1%. T-downstaging was observed in ten (30.3%) patients, whereas N-downstaging was found in 24 (72.7%) patients. Pre-treatment T stage and the interval between CCRT and operation were the predictive factors for downstaging in a univariate analysis (p=0.029, 0.027). Pre-treatment carcinoembryogenic antigen was also associated with marginal significance (p=0.068). CONCLUSION: The survival of rectal cancer patients can be better determined based on post-operative findings. Therefore, pre-operative CCRT for downstaging of the tumor seems to be important. Pre-treatment T stage and the interval between CCRT and operation can be used to predict downstaging.
Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Rectal Neoplasms ; Survival Rate

OBJECTIVES: Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. METHODS: The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. RESULTS: Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. CONCLUSIONS: Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.
Adoption ; Confidentiality ; Delivery of Health Care ; Electronic Health Records ; Hospital Information Systems ; Information Systems ; Management Information Systems ; Quality of Health Care ; Radiology Information Systems ; Referral and Consultation

PURPOSE: We wanted to evaluate the risk factors for developing lymphedema following axillary lymph node dissection in breast cancer patients. METHODS: Ninety-six patients who underwent axillary dissection for breast cancer were followed-up for up to 1 year. Lymphedema was assessed using a serial circumferential measurement method. More than a 2 cm difference in circumference was considered as clinically significant lymphedema. The effects of age, the body mass index (BMI), the cancer stage, chemotherapy, radiotherapy, the location of cancer and creating a latissimus dorsi (LD) flap on the development of lymphedema were analyzed. RESULTS: The incidence of lymphedema was increased with the advancing cancer stage. Radiotherapy was found to increase the incidence of lymphedema. Patients who had received an LD flap showed a lower incidence of lymphedema. CONCLUSION: These results could be useful as a clinical guideline for creating a management plan for postoperative lymphedema. Because there are some differences in the results between all the relevant reports, including ours, further research is needed in the form of a large, multi-center, long-term study.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema* ; Radiotherapy ; Risk Factors* ; Superficial Back Muscles

BACKGROUND: Serum separator tubes were introduced 25 years ago and are widely used in the clinical laboratory for collection of blood. Recently, the plastic serum separator tube has become available for blood collection for lightening and flexibility and suitability for automation. However few studies have been reported on stability of the common analytes in this tube. METHODS: We evaluated the concentrations of seventeencommonly ordered analytes: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total protein, albumin, sodium, chloride, calcium, phosphorus, triglyceride, low density lipoprotein (LDL)-cholesterol, potassium, uric acid, blood urea nitrogen (BUN), total cholesterol, glucose, creatinine in sera separated in plain glass tubes (no gel) and in sera separated in the plastic Greiner Bio-One Vacuette tubes containing serum separator gel (Greiner Bio-One, Kremsm?nster, Austria) by Toshiba 200-FR Neo. RESULTS: Results were analyzed using two-tailed paired t-tests and Bland-Altman plots. Results from 9 common analytes (glucose, total cholesterol, BUN, potassium, LDL-cholesterol, inorganic phosphorus, calcium, sodium, chloride) were statistically different between glass tube and plastic Greiner Bio-One Vacuette tube, but the differences were not considered to be clinically significant. CONCLUSIONS: We conclude that the plastic Greiner Bio-One Vacuette tubes are suitable for collection of blood and storage of serum for common analytes.
Alanine Transaminase ; Alkaline Phosphatase ; Aspartate Aminotransferases ; Automation ; Blood Urea Nitrogen ; Calcium ; Calcium Chloride ; Chemistry, Clinical* ; Cholesterol ; Creatinine ; Glass* ; Glucose ; Lipoproteins ; Phosphorus ; Plastics ; Pliability ; Potassium ; Sodium ; Triglycerides ; Uric Acid

A littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen. A 60-year-old man, with multiple nodules in imaging study and liver cirrhosis graded as Child-Pugh classification class A, was transferred for splenomegaly. A thrombocytopenia was found on hematological evaluation. Because there was no evidence of hematological and visceral malignancy, a splenectomy was performed for a definitive diagnosis. The histological and immunohistochemical features of the splenic specimens were consistent with a LCA. After the splenectomy, the thrombocytopenia recovered to the normal platelet count. There has been no previous report of a LCA combined with liver cirrhosis. Herein, the first case of a LCA in Korea, diagnosed and treated by a splenectomy, is reported.
Hemangioma/*complications/pathology/surgery ; Humans ; Liver Cirrhosis/*complications/pathology ; Male ; Middle Aged ; Splenectomy ; Splenic Neoplasms/*complications/pathology/surgery

BACKGROUND: Music is widely used to help a patient relax, and divert their attention from unpleasant and stressful situations. In addition, it eliminates the noise in the operating room. A light level of general anesthesia for a cesarean section is usually applied to the mother to improve the fetal safety. Therefore, there is an increased incidence of maternal explicit and implicit memory with the bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing a cesarean section under general anesthesia were allocated randomly to either a control group (group 1) or a music group (group 2). Patients in group 2 listened to music with a headphone during the procedure. The blood pressure, heart rate, intraoperative awareness, postoperative explicit and implicit memory and the plasma cortisol level were assessed. RESULTS: The systolic blood pressure and heart rate were significantly lower in group 2 than group 1 at 1 minute before intubation and 5 minutes after extubation (P <0.05). The BIS value were significantly lower in group 2 than group 1 at 1 minute after intubation and 10 minutes after delivery (P <0.05). The hit ratios of the implicit of memorial test were significantly higher in the group 2 (2.4 +/- 0.7) than in group 1 (1.6 +/- 0.4) (P <0.05). The hits of the implicit memorial test had no corresponding BIS value (P <0.05). The plasma cortisol level was significantly higher group 1 than in group 2 at 30 minutes after intubation and 10 minutes after arriving at the recovery room (P <0.05). CONCLUSIONS: It was found that the music played to the mother during a cesarean section under general anesthesia decreased the anxiety and stress response, and this technique may help protect patients from unwanted explicit and implicit memory.
Anesthesia, General ; Anxiety* ; Blood Pressure ; Cesarean Section* ; Female ; Heart Rate ; Humans ; Hydrocortisone ; Incidence ; Intraoperative Awareness ; Intubation ; Memory* ; Mothers ; Music* ; Noise ; Operating Rooms ; Plasma ; Pregnancy ; Recovery Room

Ectopic pancreas rarely produces clinical symptoms. Most commonly reported symptoms were abdominal pain, epigastric discomfort, nausea, vomiting, and bleeding. However, presentation of specific symptoms due to its size and location, including obstructive jaundice, and pyloric obstruction are possible. Ectopic pancreas is subject to various pathological changes occurring in the pancreas itself; namely, cyst, pancreatitis, hemorrhage, necrosis, and neoplastic change. We present a case of 60-year old woman with right upper quadrant pain in whom the surgical pathologic diagnosis was ectopic pancreas of the stomach complicated by pancreatitis and pseudocyst formation.
Abdominal Pain ; Diagnosis ; Female ; Hemorrhage ; Humans ; Jaundice, Obstructive ; Middle Aged ; Nausea ; Necrosis ; Pancreas* ; Pancreatitis* ; Stomach ; Vomiting

PURPOSE: Acute lower respiratory tract infections (ALRI) are one of the most common causes of morbidity in children. Most infections are known to be caused by virus and bacteria, greater percentage caused by virus than bacteria. This study was aimed to define the viral etiologic agents, age distribution, clinical manifestations, and seasonal occurrences of viral ALRI in Korean children, during 1996 and 2002. METHODS: A total of 4, 311 patients who had been hospitalized for ALRI at Samsung Medical Center, from March 1996 to September 2002, were studied. Nasopharyngeal aspirates were obtained for virus culture. Respiratory viruses were identified by indirect immunofluorescent staining. RESULTS: One or more viral agents were isolated in 14.8% (639 cases). The pathogens identified were RSV (21.8%), influenza virus type A (21.3%), adenovirus (20.7%), parainfluenza virus type 3 and 1 (17.4%, 8.3%), influenza virus type B (7.4%). The clinical patterns of viral ALRI were pneumonia (49%), bronchiolitis (22%), tracheobronchitis (15%) and croup (14%). The occurrence of viral ALRI was highest in the 1st year of life. Pneumonia was developed mostly by adenovirus. The most frequent cause of bronchiolitis was RSV. Croup was frequently caused by parainfluenza and influenza virus. Infections with influenza virus type A, B, parainfluenza virus type 1, 3, and RSV occurred in epidemics, whereas adenovirus was isolated throughout the study period. CONCLUSION: These data expand our understanding of the etiology of ALRI among pediatric inpatients in Seoul, Korea and may contribute to the prevention and control of viral respiratory tract infection.
Adenoviridae ; Age Distribution ; Bacteria ; Bronchiolitis ; Child ; Child, Hospitalized* ; Croup ; Epidemiologic Studies* ; Humans ; Inpatients ; Korea* ; Orthomyxoviridae ; Parainfluenza Virus 1, Human ; Parainfluenza Virus 3, Human ; Paramyxoviridae Infections ; Pneumonia ; Respiratory System* ; Respiratory Tract Infections* ; Seasons ; Seoul*