We report a typical case of Hunters syndrr me in a 9 year old boy, who presented with firm skin colored nodules that coalesce to form a reticular pattern on a symmetrical rea between the angles of the scapulas, which is regarded as the pathognornonic cutaneous rnarker, for Hunters syndrome. He also showed growth retardation, clear corneas, hepatomegaly, attertich deficit and mild mental deterioration. The skin biopsy specimen taken frorn a typical nodule shows loosely arranged collagen fibers with massive mucinous material which stains positively with aliar blue at both pH 2.5 and 0.5, metachromatic granules within fibroblast stained with toluidine blue.
Biopsy ; Child ; Collagen ; Coloring Agents ; Cornea ; Fibroblasts ; Hepatomegaly ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Mucopolysaccharidosis II* ; Scapula ; Skin* ; Tolonium Chloride

BACKGROUND: Trichloroacetic acid chemexfoliation has gained popularity and is widely used cosmetically. The depth of the wound caused by the various dilutions of TCA is paramount to the therapeutic efficacy. Therfore rational use of TCA chemexfoliation requires a clear understanding of the expected depth of destruction caused by a given dilution. OBJECTIVE: The purpose of this stuely is to quantitate the wound deptlw produced by varying concentrations of TCA. We have stirdied takie effects of consecutive applications, occlusion and tretinoin pretreatment on wound depth in TCA clinimical peeling. METHODS: Various concentrations of TCA and distilled water were aplied to two pairs of test sites of a guinea pigs back in a uniform fashion with cotton-tip applicators and then we have measured the mean depth of epidermal necrtsis mieroscopically by using Visual Imagc Data Analysis System. RESULTS: 1. Depths of wounds createdly threre consecutive applications of 20, 35% and 50% TCA were deeper than those of wounds by a single application of TCA. 2. Depths of wounds created by application of TCA with the occlusive method were deeper than those of the open method. Therefore the effect of occlusion is to enhance the penetration of TCA. 3. Depths of wounds pretreatwi with 0.05 % tretinoin daily for 7 days are deeper than those of the control in 50% TCA chemical peeling. Therefore the effect of 0.05% retinoin pretreatment is to enhance the penetration of TCA. CONCLUSION: This study showed that consecutive applications, oeclusion and tretinoin pretreatment in TCA chemexfoliation enhance the peietration of TCA.
Animals ; Chemexfoliation* ; Guinea Pigs ; Statistics as Topic ; Tretinoin ; Trichloroacetic Acid* ; Water ; Wounds and Injuries

The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-city, Dalseong-Gun in Teagu and Kumi-city. Data were collected between september and october 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication(p<0.05) was a predictor of improvement and knowledge about anti-tuberculosis therapy (p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075)were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.
Compliance* ; Drinking ; Drug Therapy ; Education ; Humans ; Logistic Models ; Occupations ; Recurrence ; Smoke ; Smoking ; Tuberculosis

No abstract available.
Humans ; Pityriasis* ; Tinea Versicolor* ; Treatment Outcome*

OBJECTIVE: Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. METHOD: Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X-ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. RESULTS: The ratio between male and female was 4:1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 1 30patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%) got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. CONCLUSION: In the case of weigt loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs enen though drug sensitivity restlts show sensitivity to some of them. Proper time for surgical intervention should not be delayed.
Academies and Institutes ; Busan ; Compliance ; Diagnosis ; Drug Resistance ; Female ; Hospitals, Chronic Disease* ; Humans ; Male ; Parents ; Prevalence ; Public Health ; Retreatment ; Retrospective Studies ; Thorax ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary* ; Weight Loss ; X-Ray Film

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

No abstract available.
Tinnitus*

A 51-year-old female developed a distinctive perioral rash, conisting of discrete or confluent erythematous papules for one and a half years. Histopathologic examiriation revealed upper dermal granulomas admixed with lymphoytes. Pieces of hair shaft were staincd peri-dish by AFB in the center of granuloma, which might play a role in the formation of the granuloma She also had used corticosteroid ointment intermittently duririg this time. There were no associated systemic abnormalities. The lesions resolved after two month treatment with oral corticosteroid and tetrac cline.
Dermatitis, Perioral* ; Exanthema ; Female ; Granuloma ; Hair ; Humans ; Middle Aged

A survey was conducted to study perception and attitudes of health workers towards health centers activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predomina1itly female(62.3%); had college education(60. 3%); 'and held medical and nursing positions(39.6%), technicians(30.6%) and. public health/administrativc positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker (47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Th controi, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the .urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; pefsonnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive 'perceptions, particularly' to those areas as further training needs 'and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.
Aged ; Budgets ; Child ; Child Health ; Chronic Disease ; Daegu ; Surveys and Questionnaires ; Delivery of Health Care ; Health Education ; Health Priorities ; Health Services ; Humans ; Hypertension ; Job Satisfaction ; Local Government ; Mental Health ; Nursing ; Oral Health ; Personnel Management ; Politics ; Professional Autonomy ; Rehabilitation ; Sanitation ; School Health Services ; Urban Health*

PURPOSE: The purpose of this study was to identify the therapeutic effect of orbital reconstruction by transcaruncular approach on old medial orbital wall fracture. METHODS: We performed retrospective study on 23 eyes of 23 patients, who underwent orbital reconstruction with transcaruncular approach over six weeks after injury from July 1999 to August 2001. RESULTS: Nineteen cases had enophthalmos, preoperatively; five cases; 2 mm, seven cases; 3 mm, six cases; 4 mm, and one case; 5 mm, respectively. Postoperatively, we obtained enophthalmos less than 1 mm in 17 cases(89%). The exophthalmometry revealed that enophthalmos improved from 3.2+/-0.9 mm, preoperatively to 0.9+/-0.7 mm, postoperatively. Twelve cases had diplopia on the primary and downgaze, preoperatively. However, ten cases of them(83%) disappeared diplopia, postoperatively. Of the remaining two cases, one had persistent diplopia on the downgaze and the other had paralytic strabismus. CONCLUSIONS: We believe that the medial orbital wall repair through transcaruncular approach was a good way to correct enophthalmos and diplopia on old medial orbital wall fracture.
Diplopia ; Enophthalmos ; Humans ; Orbit* ; Retrospective Studies ; Strabismus