BACKGROUND: Family physicians should actively carry out adult immunization. DM is a common risk factor of influenza and pneumococcal pneumonia related complications, so DM patients should receive influenza and pneumococcal vaccinations. The authors investigated recognition and performance of influenza and pneumococcal vaccination among DM patients. METHODS: We surveyed knowledge and performance of influenza and pneumococcal vaccination among the 203 diabetic patients living in Seoul and responding to telephone interview, who visited one DM center in general hospital from March 3, to March 7, 1997. RESULTS: Among 203 DM patients, the risk factors for influenza and pneumococcal pneumonia other than DM were old age of 65 or over(35.0%), cardiovascular diseases(5.9%) and chronic pulmonary diseases(4.9%). The recognition rate and performance rate of influenza vaccination were 27.6% and 21.2% respectively, there was a statistically significant relationship between these rates(P<0.01). Those vaccinated 43 patients for influenza knew the need of vaccination through family members and relatives(58.1%) and through medical doctors(32.6%). Although 85.2% of 203 DM patients answered that they received education about need of vaccination through DM education program conducted at hospitals, but only 9 patients(4.4%) recognized well. The reasons for not performing influenza vaccination were lack of knowledge(63.1%), no experience of influenza(12.5%), 'forget for the moment(5.0%) and regard injection as a nuisance(2.5%) in descending order. The recognition rate and performance rate of of pneurnococcal vaccination were all zero percents. The reasons for not performing pneumococcal vaccination were lack of knowledge(91.1%) no experience of pneumococcal pneumonia(6.4%), regard injection as a nuisance(1.5%) and forget for the moment(1.0%) in descending order. CONCLUSIONS: The recognition and performance rates of influenza vaccination were low and those of pneumococcal vaccination were all zero percents among DM patients because they did not recognize well the need of these vaccinations. Therefore, the doctors who see DM patients should actively recommend influenza and pneumococcal vaccination and DM educational programs must include education for these vaccinations.
Adult ; Education ; Hospitals, General ; Humans ; Immunization ; Influenza, Human* ; Interviews as Topic ; Physicians, Family ; Pneumonia, Pneumococcal ; Risk Factors ; Seoul ; Vaccination*

BACKGROUND: This study examined the efficacy of patient-controlled epidural analgesia (PCEA) for post-cesarean section pain control and compared the suitability of four different volumes of continuous background infusion (CBI). METHODS: Sixty patients were received 0.125% bupivacaine with 5 g/ml fentanyl by PCEA (2 ml of demand dose and 10 minutes of lockout interval) and CBI. Experimental groups were divided four groups according to the volumes of CBI; 1 ml/hr, 2 ml.hr, 3 ml/hr and 4 ml/hr of CBI during 48 hours postoperatively. RESULTS: Total amount of fentanyl and bupivacaine consumption was significantly higher in 1ml/hr of CBI group than 2 ml/hr of CBI group during first 24 hours, and in 4 ml/hr of CBI group than 1 ml/hr and 3 ml/hr of CBI group during second 24 hours. CBI/maximum hourly demand dose was 15~23%. There is no significant difference between the groups in pain score, side effects and patient's satisfaction. CONCLUSIONS: This study suggests that two or three ml/hr of CBI can provide the most effective postoperative analgesia and the optimal ratio of CBI/maximum hourly demand dose is about 20%.
Analgesia ; Analgesia, Epidural* ; Bupivacaine ; Fentanyl ; Humans

No abstract available.
Animals ; Dogs* ; Neurons*

No abstract available.
Vasculitis*

BACKGROUND: In recent years, estrogen has also been shown to modulate the development and function of the brain, bur not exclusively in areas involved with sexual behavior. Among the most novel and fascinating effects of estrogen are those on cognitive function and memory process and their alterations during aging and neurodegenarative disease like Alzheimer. Estrogen receptors distributed not only in the hypothalamus but many different areas, like cerebral cortex, hippocampus, basal forebrain, midbrain, spinal cord, and the diverse action of estrogen is supported by this fact. Numerous studies suggest thai estrogen may be beneficial in preserving cognitive function, but it is not clear yet. PURPOSE: In this study, we perform the immunohistochemical staining in the hippocampus of normal aged rat, and show the distribution of estrogen receptor compared with the neonatal rat. METHODS: we have used antibodies against a estrogen receptor(ER)-alpha to determine their distribution in neonatal and aged SD rat hippocampus. RESULTS: In neonatal rat hippocampus, ER-alpha immunoreactivity was observed in the nucleus of Purkinje cells, whereas in aged rat hippocampus, ER-a immunoreactivity was found mainly in the cytoplasm of Purkinje cells. CONCLUSION: We showed the age related intracellular differential distribution of ER-alpha immunoreactivity in the rat hippocampus. But, further investigations are required to establish whether functional relations like cognitive ability exist with this different intracellular expression of ER-alpha immunoreactivity.
Aging ; Animals ; Antibodies ; Asian Continental Ancestry Group ; Brain ; Cerebral Cortex ; Cytoplasm ; Estrogens* ; Hippocampus* ; Humans ; Hypothalamus ; Memory ; Mesencephalon ; Prosencephalon ; Purkinje Cells ; Rats* ; Receptors, Estrogen ; Sexual Behavior ; Spinal Cord

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.
Arthritis ; Cellulitis* ; Complement System Proteins ; Erythema ; Exanthema ; Female ; Fever ; Humans ; Knee ; Lupus Erythematosus, Systemic* ; Meningitis ; Meningococcal Infections ; Middle Aged ; Neisseria meningitidis ; Sepsis ; Skin ; Skin Manifestations ; Urticaria

Neisseria meningitidis is an important cause of sporadic meningitis and fatal sepsis. Skin manifestations like urticaria, maculopapular eruption, and petechial rash occur in the majority of patients with meningococcal infections. However, meningococcal cellulitis is extremely rare and has not been reported in patients with systemic lupus erythematosus (SLE). SLE patients who have low complement level are more susceptible to meningococcal infections than healthy population with normal complement level. We report a case of cellulitis associated with meningococcal infection, which manifested as knee arthritis, skin erythema, and low grade fever mimiking SLE flare in a 54 year-old female patient who had long standing SLE and hypocomplementemia.
Arthritis ; Cellulitis* ; Complement System Proteins ; Erythema ; Exanthema ; Female ; Fever ; Humans ; Knee ; Lupus Erythematosus, Systemic* ; Meningitis ; Meningococcal Infections ; Middle Aged ; Neisseria meningitidis ; Sepsis ; Skin ; Skin Manifestations ; Urticaria

No abstract available.
Gestational Sac* ; Ultrasonography*

BACKGROUND: The main function of melanocyte is known to protect the skin from hazardous sunlight. But, some investigators have claimed lately that melanocytes are also related to the immunologic role in the epidermis because these cells produce IL-1 activity and IL-1beta convertase activity, in vitro. OBJECTIVE: Our purposes were to investigate the effects of rIFN-gammaon the proliferation of melanocytes, melanin content, and the expression of HLA-DR antigen on melanocytes after a rIFN-gammaexposure. MEHTODS: The number of melanocytes, the melanin content, and the expression of HLA-DR antigen were evaluated on cultured human melanocytes according to a time sequence and various concentrations of rIFN-gamma. RESULTS: Antiproliferative activity on melanocytes was dependent on the exposure time and the concentration of rIFN-gamma. According to the exposure time and the concentration of rIFN-gamma, melanogenic acivity was inhibitd or stimulated. Normal melanocytes didn't express HLA-DR antigen, but when normal melanocytes were exposed to rIFN-gamma, the expression of HLA-DR antigen increased in a time-and concentration-dependent fashion. After the removal of rIFN - gammafrom the culture media, the expression of HLA-DR antigen on melanocytes also disappeared. CONCLUSION: In our study, melanocytes seem to be related to the immunologic role in the epidermis because these cells expressed HLA-DR antigen after rIFN-gammaexposure and we think that study could help to investigate between melanocytes and immunologic mechanisms in various inflammatory skin diseases.
Culture Media ; Epidermis ; HLA-DR Antigens* ; Humans* ; Interleukin-1 ; Melanins ; Melanocytes ; Research Personnel ; Skin ; Skin Diseases ; Sunlight

Nephroblastoma is the most common tumor of childhood and accounts for 20.4% of all neoplasms in pediatric patients but, nephroblastoma in adult is very rare. A total of 167 cases have been reported in the World Medical Literature. A case of nephroblastoma in adult was presented with a brief review of the literature.
Adult* ; Humans ; Wilms Tumor*