OBJECTIVES: The aim of this study was to compare differences in perception and knowledge of child abuse and child disciplinary practices according to the history of child abuse victimization. METHODS: A questionnaire survey on child abuse was conducted with 491 adults raising children. We compared the perception and knowledge of child abuse and child disciplinary practices between two groups of adults with and without a history of childhood abuse victimization. RESULTS: The group with a history of childhood abuse had lower levels of knowledge of child abuse (F=6.990, p<0.01) and engaged in more negative disciplinary practices (F=5.974, p<0.05) than those without. However, no differences in the perception of child abuse were observed between the two groups. CONCLUSION: The results suggest that adults with a history of childhood abuse have lower levels of knowledge of child abuse and use more negative disciplinary practices in raising their children. This highlights the need to administer not only educational but also more direct hands-on interventions to vulnerable parents in order to foster healthy parenting and disciplinary practices.
Adult ; Child ; Child Abuse ; Child ; Crime Victims ; Humans ; Parenting ; Parents

OBJECTIVES: A previous study conducted in 2000 measuring the heart rate variability (HRV) of carbon disulfide (CS2)-poisoned subjects suggested that their HRV was reduced after exposure cessation. However, the study was limited by the following procedural limitations: (1) only 71 CS2-poisoned subjects participated, (2) no females participated, and (3) the CS2-poisoned subjects were older than the controls. This study was therefore conducted to overcome these limitations of the earlier study. METHODS: The study subjects comprised 122 retired workers with CS2 poisoning and the same number of age- and sex-matched controls. Information on individual age, sex, height, weight, smoking history, alcohol drinking, regular exercise, medical and occupational history, chest x-ray, and ECG recording of the two groups was collected though a self-administered questionnaire and a medical examination. Standard Deviation of NN intervals (SDNN), Root-Mean-Square of Successive Differences (RMSSD), Total Power (TP), Low Frequency (LF), High Frequency (HF), and LF/HF ratio were measured as HRV indices for 5 minutes in the sitting position. RESULTS: Univariate analysis revealed that all HRV indices of CS2-poisoned subjects were lower than those of the controls. Multiple linear regression analysis showed that CS2 poisoning had negative association with all HRV indices and that its association with RMSSD was statistically significant (P<0.05). CONCLUSIONS: This study suggests that CS2-poisoned subjects continue to have reduced HRV, even though the exposure has ceased.
Alcohol Drinking ; Carbon Disulfide* ; Carbon* ; Electrocardiography ; Female ; Heart Rate* ; Heart* ; Humans ; Linear Models ; Poisoning ; Questionnaires ; Smoke ; Smoking ; Thorax

We report a case of a 67-year-old woman with giant cell tumor of the temporal bone. A 67-year-old woman presented with localized tenderness, swelling, sensory dysesthesia, dizziness, and headache over the left temporal bone. She was neurologically intact except left hearing impairment, with a nonmobile, tender, palpable mass over the left temporal area. A brain computed tomography(CT) scans showed a relatively well defined heterogenous soft tissue mass with multiple intratumoral cyst and radiolucent, osteolytic lesions involving the left temporal bone. The patient underwent a left frontotemporal craniotomy and zygoma osteotomy with total mass removal. Permanent histopathologic sections revealed a giant cell tumor. She remains well clinically and without tumor recurrence at 2 years after total resection.
Aged ; Brain ; Craniotomy ; Dizziness ; Female ; Giant Cell Tumors* ; Giant Cells* ; Headache ; Hearing Loss ; Humans ; Osteotomy ; Paresthesia ; Recurrence ; Temporal Bone* ; Zygoma

The aim of our study was to investigate the correlation of the proliferative activity of pituitary neoplasms with clinical characteristics and recurrences. Tumor specimens were obtained from 44 consecutive patients with pituitary macroadenomas who underwent surgery between July 1998 and August 2003. Specimens were immediately fixed in 10% buffered formalin and then embedded in paraffin. The Ki-67 antigen was assessed by immumohistochemical analysis using the monoclonal antibody. We investigated the correlation of the Ki-67 labeling index with the following clinical and radiological characteristics: sex, age, presence or absence visual field defect, tumor classification, maximal tumor diameter, Hardy's classification, type of tumor, invasiveness, and recurrence. Our study suggests that the clinical characteristics such as visual field defect and recurrence are correlated with the high Ki-67 labeling index. No statistical differences were observed in the Ki-67 labeling index in relation to the following characteristics: sex, age, tumor classification, maximal tumor diameter, Hardy's classification, type of tumor, and invasiveness into the sphenoid sinus or cavernous sinus.
Adenoma/metabolism/*pathology/radiography ; Adult ; Aged ; Comparative Study ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/*analysis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms/metabolism/*pathology/radiography

BACKGROUND/AIMS: Three dimensional (3-D) ultrasonography is definitely more accurate than conventional 2-D ultrasonography in volume measurement of intra-abdominal organs. However, its application in measuring gastric emptying time has been limited. Thus, we tried to measure gastric antral emptying time by using 3-D ultrasonography and compare with that by radio-scintigraphy. METHODS: We performed both 3-D ultrasonography and radio-scintigraphy on the same day in 23 healthy subjects. After overnight fast, the subjects ingested 500 mL of soup meal (84 Kcal) that had been pre-mixed with 1 mCi of technetium(99m). The half emptying time (T(1/2)) measured by 3-D ultrasonography was defined by the time when the gastric antral volume decreased to half. RESUTLS: The mean T(1/2) of 23 healthy subjects measured by 3-D ultrasonography was 23.4 +/- 10.5 min, while that measured by scintigraphy was 28.4 +/- 14.4 min. The difference (p=0.11 by paired t-test) between the two methods was not significant. Moreover, no significant correlation of T1/2 between the two methods (r=0.361, p=0.09) was observed. CONCLUSIONS: Measuring gastric antral emptying time with 3-D ultrasonography may be useful but require further validation studies and advance in technology.
Adult ; English Abstract ; Female ; *Gastric Emptying ; Humans ; *Imaging, Three-Dimensional ; Male ; Stomach/radionuclide imaging/*ultrasonography ; Technetium/diagnostic use

OBJECTIVES: The purpose of the present study was to estimate the prevalence of metabolic syndrome and to investigate the relation between metabolic syndrome and heart rate variability in a community population. METHODS: The study design was cross-sectional, and 1028 subjects, aged 20~87 years, were recruited. Heart rate variability was measured in the sitting position for five minutes. The recorded data were assessed by time-domain (standard deviation of RR interval) and frequencydomain analysis. All subjects were examined for five components of metabolic syndrome. RESULTS: The prevalence of metabolic syndrome in male and female subjects was 25.9% and 27.7%, respectively. The mean value of heart rate variability of the subjects was significantly different between healthy subjects and those with metabolic syndrome. The regression model showed that metabolic syndrome was negatively correlated with heart rate variability. CONCLUSIONS: The results demonstrate that metabolic syndrome has potentially negative effects on the cardiovascular system, and that these effects could be detected by heart rate variability. Follow-up studies able to control the cohort effect are necessary to evaluate the relation between metabolic syndrome and heart rate variability.
Cardiovascular System ; Cohort Effect ; Female ; Heart Rate* ; Heart* ; Humans ; Male ; Prevalence

Granular cell tumor is mostly benign and thought to be of Schwann cell origin. The head and neck, particularly tongue, breast, and upper respiratory tract are frequently involved. Recently, we have experienced a case of granular cell tumor of the right thigh in a 30-year old male, diagnosed by fine needle aspiration cytology which revealed distinct cytologic features. The smear revealed cellular aspirates with clear background. The tumor cells showed uniform small nuclei and abundant eosinophilic, granular cytoplasm with hazy cell border. Mitoses were not found.
Adult ; Biopsy, Fine-Needle ; Breast ; Child* ; Cytoplasm ; Eosinophils ; Granular Cell Tumor ; Head ; Humans ; Lupus Nephritis* ; Male ; Mitosis ; Neck ; Paraganglioma ; Respiratory System ; Statistics as Topic* ; Thigh ; Tongue

PURPOSE: The pathophysiologic mechanisms and risk factors of renal functional deterioration are still controversial. We analyzed the factors associated with renal failure in children with primary vesicoureteral reflux. METHODS: The medical records of 166 children who were diagnosed with primary vesicoureteral reflux from Jan. 1985 to Dec. 1996 in the Department of Pediatrics, Seoul National University Children's Hospital were reviewed retrospectively. The patients were divided into two groups according to renal function: patients with renal failure(RF group) and patients with normal renal function(NRF group). RESULTS: Eighteen(11%) were classified as RF group, and 16(89%) of them were male. Sixteen (89%) of RF group revealed decreased renal function at the time of diagnosis. There was no past history of documented urinary tract infection in 16(89%) of RF group. Patients of RF group had a higher grade of reflux as compared with those of NRF group. Proteinuria and hypertension were found in 16(89%) and 6(33%) of RF group, respectively, while no NRF patients had proteinuria or hypertension. Renal functional deterioration had progressed to end-stage renal disease in 6(33%) of RF group during a mean follow-up of 4.4+/-2.7(range 0.5-12) years. CONCLUSION: Reflux nephropathy and renal scar in children can be prevented, in some cases, by early diagnosis of vesicoureteral reflux and prophylaxis of urinary tract infection. Regular check up for proteinuria and hypertension is essential for early detection of renal dysfunction. However, in other patients, especially in male, renal dysfunction can develop independently on urinary tract infection.
Child* ; Cicatrix ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Medical Records ; Pediatrics ; Proteinuria ; Renal Insufficiency* ; Retrospective Studies ; Risk Factors ; Seoul ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: This study was designed to aid the diagnosis and to predict the outcorne by understanding the clinical course of nutcracker syndrome in childhood. METHODS: The clinical, laboratory, radiological and cystoscopic data from the medical records of eleven children who were diagnosed as nutcracker syndrome by gross hematuria and pressure gradient criteria (>3mrnHg) were studied retrospectively and analyzed. RESULTS: Sex ratio of the cases was 7:4, and the median age of onset was 12.8 (3-14.3) years. Six cases showed persistent and 5 cases manifested interrnittent, exercise induced hematuria. Left flank pain (64%), abdominal pain (18%), left varicocele (9%) were associated in some of the children, but hematuria was the only symptom in 36Yo. Left renal vein entrapment was documented in 10 cases by ultrasonography. Out of the 5 cases studied by renal Doppler ultrasonography, 4 and 5 cases showed higher (>5) mean left renal vein diameter ratio (Distal/ Aortomesenteric portion) and mean peak velocity ratio respectively. Unilateral bleeding from left ureteral orifice was documented in 7 of the 9 cases at cystoscopy. The mean pressure gradient between proximal left renal vein and inferior vena cava was 4.4+/-1.6 (3-7) mmHg. Hematuria of 25% and 57% of the cases disappeared spontaneously in 3 and 5 years after onset respectively. Proteinuria disappear- ed in 3 of the 5 initial proteinuric cases. CONCLUSION: Nutcracker syndrome must be considered in the differential diagnosis of non-glomerular, especially gross hematuria in childhood, and Doppler ultrasonography can aid diagnosis non-invasively. The renal function remained stable, but 4396 of the cases continued to show hematuria still 5 years after onset.
Abdominal Pain ; Age of Onset ; Child ; Cystoscopy ; Diagnosis ; Diagnosis, Differential ; Flank Pain ; Hematuria* ; Hemorrhage ; Humans ; Medical Records ; Proteinuria ; Renal Veins ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Ultrasonography, Doppler ; Ureter ; Varicocele ; Vena Cava, Inferior

Pulmonary hemorrhage is a rare but possibly fatal complication of systemic lupus erythematosus (SLE). We report a case of massive pulmonary hemorrhage in a 14-year-old boy recently diagnosed as SLE. He developed massive pulmonary hemorrhage during the courses of i.v. methylprednisolone pulse therapy, and did not respond to i.v. cyclophosphamide. However, he rapidly improved through the use of plasmapheresis. Although various factors can precipitate pulmonary hemorrhage in SLE, our case was probably caused by an immune mediated mechanism since the hemorrhage responded promptly to plasmapheresis. This case illustrates the importance of plasmapheresis in the treatment of pulmonary hemorrhage which is not improved by methylprednisolone and cyclophosphamide. We report this case with a brief review of the related literatures.
Adolescent ; Child* ; Cyclophosphamide ; Hemorrhage* ; Humans ; Lupus Erythematosus, Systemic* ; Male ; Methylprednisolone ; Plasmapheresis*