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: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

BACKGROUND: The authors studied to estimate the frequency of irregular antibodies and their significance in blood transfusion and antenatal care in Korea. METHODS: Irregular antibodies were tested by immediate saline spin, 37degrees C albumin and antiglobulin test for 2,008 transfusion candidates and 1,047 pregnant women at Severance hospital using commercial screening and identification cells (Dade, U.S.A.). RESULTS: The irregular antibodies were detected in 38 (1.24%) of total 3,055 subjects (transfusion candidates: 0.9%, pregnant women: 1.91%) . In transfusion candidates, the detected antibodies were Lewis antibodies, cold antibodies (anti-M, anti-P 1), Rh antibodies and unspeified warm antibodies, and their distributions were 56%, 22%, 17%, and 5%, respectively. In pregnant women, the detected antibodies were Lewis antibodies, Rh antibodies, anti-Jra, and unspeified warm antibodies, and their distributions were 45%, 45%, 5% and 5%, respectively. At immediate saline phase, 58% of irregular antibodies were detected. At 37degrees C albumin phase, 90% of irregular antibodies were detected and only 10% of irregular antibodies were detected at antiglobulin phase. CONCLUSIONS: Although the prevalence rates of clinically important irregular antibodies were low, 1/1000 of irregular antibodies could not be detected. Therefore, irregular antibody screening should be performed in all pretransfusion test. And, if antibody detection tests are negative, immediate saline crossmaching methods are acceptable in Korea.
Antibodies* ; Blood Transfusion ; Coombs Test ; Female ; Humans ; Korea* ; Mass Screening ; Pregnant Women* ; Prevalence*

Heterotopic ossification(HO) is a frequent complication of total hip arthroplasty(THA), If it is sevre enough, it can convert a successful result of the operation into a poor one. Among several strategies that researches in recent years have tested, radiation therapy have been accepted to have efficacy for prevention of heterotopic ossification by many authors. While postoperative irradiation has been shown to lower the incidence of HO effectively in high risk patients following THA, patients in multiple dose protocols continue to develop some heterotopic ossifiction despite therapy and have some problems. Ninteen patients received single dose exposure to 600 rad delivered within 48 hours of THA with shielding of prosthesis region. The patients were considered high risk group for developing HO because of hypertropic osteoarthritis, post-traumatic osteoarthritis or the presence of previous formed ectopic bone. The average follow up period was 10.2 months(range 6 months
Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Humans ; Incidence ; Ossification, Heterotopic ; Osteoarthritis ; Osteogenesis ; Prostheses and Implants

Malignant hyperthermia is defined as a potentially fatal hypermetabolic syndrome characterized by hyperpyrexia, skeletal muscle rigidity, tachycardia, respiratory and metabolic acidosis, cyanosis etc. Any inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catastrophic reaction. This case is presented of a 37 year old female patient in whom total gastrectomy was planed to perform under oxygen-nitrous oxide-isoflurane anesthesia with induction by thiopental sodium and succinylcholine. When administer of succinylcholine to induction, the jaw was very tight and the mouth was impossible to open. We retried with vecuronium and the jaw was slightly resistant to opening, but intubation was successfully performed. After induction, hyperpyrexia, tachycardia, increased end-tidal carbon dioxide developed. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated successfully with early detection and intensive care. According to decrease of temperature and normalization of arterial blood gas, the procedure continued with nontriggering agent, fentanyl. The etiologic factors, clinical features, treatment and preventive measures of malignant hyperthermia are discussed.
Acidosis ; Adult ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Carbon Dioxide ; Cyanosis ; Emergency Treatment ; Female ; Fentanyl ; Fever ; Gastrectomy ; Humans ; Inhalation ; Critical Care ; Intubation ; Isoflurane ; Jaw ; Malignant Hyperthermia* ; Mouth ; Muscle, Skeletal ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide

No abstract available.
Female ; Perinatal Mortality* ; Pregnancy ; Pregnancy, Multiple*

Sudoriparous angioma is an unusual form of angioma with pain and hyperhidrosis. We present two cases of typical sudoriparous angioma. Case 1: 9-year-old female showed 0. 8 to 2. 0cm multiple dark brownish tender palpable hypertrichotic masses on the right lower leg after birth. Muscular atrophy and flexion contracture was also developed on the right lower leg for 2 years. Case 2: 4-year-old rnale showed 3 * 3cm tender elevated mass on the left shin after birth. Marked hyperhidrosis was developed when even slight pressure applied on the lesion in these cases. On histologic examination, these two cases showed proliferation of varible sized blood veasels hyperplasia and dilated hyperplastic eccrine glandular and ectopic adipose tissue on the mid and deep dermis. Muscular biopsy from case 1 showed fibrotic and degenerative change. Electromicroscopic examination done from case 1. The secretory epithelial cell of eccrine gland showed cytoplastic degradation and slight dilated intercellular canaliculi (Fig. 11). The lumen of subepithelial capillaries were dilated and some of endothelial cells showed degenerative changes evidenced by RER dilation, mitochondrial swelling and detachment from underlying tissue(Fig. l2). The cutaneous nerve showed many non-myelinated axons enclosed in cytoplasm of Schwann cells.
Adipose Tissue ; Axons ; Biopsy ; Capillaries ; Child ; Child, Preschool ; Contracture ; Cytoplasm ; Dermis ; Eccrine Glands ; Endothelial Cells ; Epithelial Cells ; Female ; Hemangioma* ; Humans ; Hyperhidrosis ; Hyperplasia ; Leg ; Mitochondrial Swelling ; Muscular Atrophy ; Parturition ; Schwann Cells

It is thought that the sanitary perception and hygienic food treatment of food suppliers as the first handlers of foodstuffs are extremely significant for the safe and sanitary management of food in group meal services. So in this study, a survey of 103 food suppliers who provide raw materials for 80 meal services in business places around Buasn area was conducted on general matters, participation in sanitation education, sanitary perception, sanitary treatment of foodstuffs, knowledge of sanitation, etc. The results of the survey are as follows: 1. 42.7% of the subjects have worked for the food supply companies for one to five years and the main job of 36.9% of them is delivery service. Food suppliers who handle over two foodstuffs are 6839%. 2. Concerning the participation in sanitation education, 43.7% of the subjects have not experienced any such education, The reason of 23.3% of them for not having the education is that there have been no opportunity for them at all. And 83.5% of them regard the education on hygiene as necessary. 3. In the sanitary perception, 93.1% of the subjects considered the temperature control of the food delivery vehicles as important and 82.5% of them replied on of the leading causes of food poisoning as foodstuffs. 64.0% thought of their knowledge of food sanitation as not very good, but moderate. 4. Concerning sanitary treatment of foodstuffs, 50.5% of delivery vehicles were wearing sanitary uniforms and 24.3% of them washed their hands while supplying food. 5. In the score of hygienic knowledge, the average score of all food suppliers was 60.6 point. In the score of hygienic knowledge on general matters, managing supervisors got 6.31+/-1.81, meat suppliers scored 7.08+/-1.37 and suppliers with 5 to 10 year careers recorded the highest point, 6.37+/-1.70. In the score of hygienic knowledge based on the perception of food sanitation, the food suppliers with the experience of sanitation education scored 6.42+/-1.93 point and the point was significant(p<0.01), compared with that of the food suppliers without the experience of sanitation education. The food suppliers who answered their knowledge was very good scored the highest point, 8.00+/-1.41. The food suppliers who replied that sanitation education was truly necessary recorded the hygienic knowledge score of 6.75+/-1.77, significantly(p<0.01) high. In the score of hygienic knowledge on the basis of the practical degree of sanitary handling of food materials, the food suppliers who answered they cleaned their delivery vehicles everyday scored 6.48+/-1.93, the food suppliers who answered they sterilized their delivery vehicles everyday scored 6.29+/-1.89, the food suppliers who answered they controlled the themperature of their delivery vehicles irregularly scored 6.58+/-1.79 and the food suppliers who answered they washed their hands every time when they were working scored 6.86+/-2.24, significantly(p<0.05) high in comparison with every item in other factors. And the food suppliers who answered they were wearing sanitary uniforms irregularly while suplying foodstuffs scored the highest point, 6.66+/-2.92.
Busan* ; Commerce* ; Education ; Food Supply ; Foodborne Diseases ; Hand ; Hygiene ; Meals ; Meat ; Sanitation

PURPOSE: This study was done to examine the incidence of pressure ulcers and associated factors, by inspecting the skin of newborn babies in a newborn unit or newborn intensive care unit (NICU). METHODS: The participants were 101 newborn babies in either a newborn unit or NICU in D general hospital. The incidence of pressure ulcer was measured using the skin inspection tool for pressure ulcer, suggested by Agency for Health Care Policy and Research. RESULTS: Incidence rate of pressure ulcer was 19.8%, and 80% of the newborns with pressure ulcers were premature babies. The commonest region of onset was the ear (36.8%), followed by the foot (31.6%), occipital region (15.8%) and knee (15.8%). Those are the regions related to external medical devices like nasal Continuous Positive Airway Pressure and Pulse Oximetry. Factors related to pressure ulcers were gestational period of 37 weeks or less, hospitalization for 7 days or more, birth weight under 2,500 g and a low level of serum albumin. CONCLUSION: The results of the study show that the skin and underlying tissues of premature infants is at risk for pressure-related skin breakdown. As most pressure ulcers are caused by medical devices, nursing interventions are required to prevent further aggravation of the lesions.
Birth Weight ; Continuous Positive Airway Pressure ; Delivery of Health Care ; Ear ; Foot ; Hospitalization ; Hospitals, General ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care Units ; Knee ; Nursing Care ; Oximetry ; Pressure Ulcer ; Skin ; Child Health

Nethertons syndrome is characterized by a triad of ichthyosiform dermatosis, multiple hair-shaft defects(including trichorrhexis invaginata), and an atopic diathesis. Intermittent amminoaciduria, mental retardation, or recurrent infection have been observed in some cases. We have seen an 8-year-old girl presenting with polycyclic, erythematous patches bordered by distintive double-edged scales as a skin manifestation and ball-and-socket deformity as a hair defect.
Child ; Congenital Abnormalities ; Disease Susceptibility ; Female ; Hair ; Humans ; Intellectual Disability ; Skin Diseases ; Skin Manifestations ; Weights and Measures