No abstract available.
Methionine*

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*

Because clinical course of the Legg-Calve'-Perthes disease (LCPD) is varied and unpredictable, it is important that pediatric orthopedists have to know prognostic factors of LCPD in order to choose proper method of treatment. The most universally accepted prognostic factor is the patient's age at the onset of the disease, and most patient's who are less than 5 years old have been treated non-operatively. However, we believe that the extent of involvement of the femoral head is more important in this age group and that operative treatment can get good results in cases of servere head involvement. The purpose of this study is to evaluate the efficacy of femoral varus osteotomy in patients before the age of 5 years with severe involvement. We reviewed 18 patients (23 hips) who were less than 5 years old with Catterall group III (5 patients, 7 hips) or IV (13 patients, 16 hips) involvement from June 1984 to June 1994. Femoral varus osteotomies were performed in all cases. We followed up more than 2 years (range, from 24 to 130 months) and analysed clinical and radiological results. The results were as follows: 1. The mean duration from onset of the disease to the stage of repair was 16 months (range, from 8 to 27 months). 2. 2 hips (28.6%) in group III and 12 hips (75%) in group IV showed radiographic head at-risk signs. 3. Clinically all hips in group III showed good result. However, among the 16 hips in group IV, 13 hips were rated good and 3 hips were fair. Overall, 20 hips (86.9%) showed good result. 4. Radiologically all hips in group III showed good result, whereas in group IV, 10 hips were rated good and 6 hips were fair. Overall, 17 hips (78.9%) showed good result. We concluded that femoral varus osteotomy in patients less than 5 years old with severe involvement might shorten the course of disease and might be effective method.
Child* ; Child, Preschool* ; Fibrinogen ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease* ; Osteotomy*

It is well-known that early diagnosis and treatment is still the most important aspect of congenital dislocation of the hip. However, the orthopaedist can not see the cbildren with dislocated hip before they begin to Walk, especially in the developing countries. When the children with dislocated hips are discovered lately,it is impossible to reduce the hip by simple manipulation, and also is very difficult to maintain the reduction successfully. Our method of treatment was based on the concept that the various components of the abnormal joint will develop satisfactorily into a normal hip provided acccurate congrucus and concentric reduction is obtained as early as possible to take advantage of the maximum growth potential, and is maintained throughout growth, In this study 16 children with 18 dislocated hips among the 75 children with congenitally dislocated hips were primarily treated by open reduction,followed by 3 weeks of temporary fixation of reduced hip by Kirschner wire and 6 weeks of cast immobilization from November 1973 to April 1979. They were clinically and roentgenologically analized. The end results of treatment were assessed by 3 roent- genological determinants; the medial joint space, the acetabular angle and the centeredge angle. The results obtained were as follows: 1. The pathologically widened medial joint space of hip or hips decreased rapidly during first 6 months after reduction, irrespective of the age at reduction, and satisfactory results were obtained in 83 per cent indicated by joint space distance less than 10 mm. 2. Postoperative Kirschner wire fixation of reduced hip to maintain the reduced position did not impair the physeal growth or bring the joint stiffness. 3. The acetabular angle improved rapidly during the first year after reduction in all age groups of patients and thereafter the rate of acetabular development decreased, but the acetabular angle continued to improve throughout the period of observation and satisfactorily (less than 25 degrees) developed in 83 per cent of children. 4. The center-edge angle increased rapidly during first three months after reduction and was satisfactory (more than 20 degrees) in 78 per cent. Overall success rate of treatment was 81.3 per cent. 5. Assessment of end results by medial joint space has more advantages in evaluating the result of treatment because of the aimplicity of it's measurement and leas error regardless of the change of patients position on roentgenagrams. 6. There were only few complications (11.1%) after surgical treatment; coxa magna in a case and resubluxation in another case were complicated. 7. Parameters utilized for assessing the results were faund to be the very helpful criteria to evaluate the hip development indicated by cephalocotyloid relation when used together. 8. Simultaneous open reduction followed by temporary internal fixation with K-wire was found to be recommendable method of treatment ae a first choice of treatment even in children under age of 3 if once nonsurgical reduction fails; because by this type of treatment more easily and accurately concentric reductions were obtained, and also reduction was more easily maintained without subsequeat redislocation.
Acetabulum ; Child ; Developing Countries ; Dislocations ; Early Diagnosis ; Hip ; Humans ; Immobilization ; Joints ; Methods

To determine whether personal history of lactation in premenopausal women influence bone mineral density, a cross-sectional study was conducted. One hundred eighty-four premenopausal women were selected from women who had been checked for bone mineral density by dual energy x-ray absortiometry in lumbar spine, femoral neck, Ward's triangle, and trochanteric site at general hospitals in Seoul and Pusan. They completed a questionnaire including life style factors and reproductive history. In the data analysis, Pearson correlation coefficients were used to test any association between individual variables and bone mineral density and a statistical comparisons between long term lactation(>24 months) and short term lactation(<24 months) were made by one way analysis of covariance. The results were summarized as follows: 1) There was no significant difference in the bone mineral density of the lumbar vertebrae in premenopausal women between the long term lactation group(>24months) and the short term lactation group(<24months). 2) There was no significant difference in the bone mineral density of the femur neck, Ward's triangle, and trochanteric site in premenopausal women between the long term lactation group (>24months) and the short term lactation group (<24months). Considering these results, we suggest prospective studies that measure bone mineral density before and after, in addition to those during lactation. We also suggest the further study with premenopausal women less than 35 who have achieved peak adult bone mass.
Adult ; Bone Density* ; Breast Feeding* ; Breast* ; Busan ; Cross-Sectional Studies ; Female ; Femur ; Femur Neck ; Hospitals, General ; Humans ; Lactation ; Life Style ; Lumbar Vertebrae ; Surveys and Questionnaires ; Reproductive History ; Seoul ; Spine ; Statistics as Topic

No abstract available.
Staphylococcal Scalded Skin Syndrome*

Epidermal cysts may develop on any part of the body. Most of them are thought to occur following inflammation of the epithelium of the hair follicle. These found on the palm and sole where the hair follicle is absent have been considered to developmant of following a traumatic inclusion of the epidermis into the Dermis. Because only a few cases w re known to be related to preceding trauma, the latter assumption has been questioned. Reerly, the HPV-like virions and papillomavirus genus-speciric antigen were detected in the epicrml cyst of the sole in some reports. 1 our cases of plantar epidermal cyst were studied for the presence of human papillomavirus using conventional histologic and immunohistochemical examinator Histologic examination showed three characteristic findings, that is, intracytoplasmic eosinophil odies in the cyst wall, parakeratosis within the cyst caviti, and vacuolar structures disperse the wall and cavity. In all of the cases, immunohistochernical staining was positive for papule evirus antigen. These findings suggest an etiologic as.iation between the papillomavirus infection and plantar epidermal cyst.
Dermis ; Eosinophils ; Epidermal Cyst* ; Epidermis ; Epithelium ; Hair Follicle ; Humans* ; Inflammation ; Papilloma* ; Papillomavirus Infections ; Parakeratosis ; Virion

The abdominal manifestations of tuberous sclerosis are most frequently related to hamartomas of the kidneys which are readily detectable on CT scans because of their fat content. However, lipomas or angiomyolipomas of the liver are quite rare. Two patients with angiomyolipomas of the kidney had typical kin lesions of tuberous sclerosis. Orie had been on long-term dialysis for chronienal failure due to an angiomyolipomatous lesions and the other had undergone nephrectomy because of nonfunction kidney. Hepatic hamartomas were also seen in both atients. We should anticipate that such masses are not infrequent with uberous sclerosis.
Angiomyolipoma* ; Dialysis ; Hamartoma ; Humans ; Kidney ; Lipoma ; Liver ; Nephrectomy ; Renal Insufficiency* ; Sclerosis ; Tomography, X-Ray Computed ; Tuberous Sclerosis*

Pancreatic ductal rupture can be an elusive diagnosis. The early signs and symptoms are often vague, and when it goes unnoticed, ductal rupture results in inceased morbidity and mortality. Unfortunately, no diagnoatic test has proven reliable in its timely detection. Endoscopic retrograde cholangiopancreatography (ERCP) is routinely utilized to visualize the anatomy of the pancreatic duct in elective situation. But the utilization of emergent ERCP will allow detection of pancreatic rupture in clincal settings where surgery might not otherwise have been prompted by complications. In addition, present, timely visualization of the pancreatic duct will permit intelligent planning for pancreatic sugery. Recently, we experienced a case of 36-year-old female who had upper abdominal blunt trauma with heavy iron. Her serum amylase was high but the physical examination was vague. Emergent ERCP was performed and it revealed dye leak from rurptured pancreatic duct at tail portion of pancreas. Emergent distal pancreatectomy and splenectomy was successfully performed. So we report this case with a review of literatures.
Adult ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Humans ; Iron ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Physical Examination ; Rupture ; Splenectomy

The wandering spleen is a rare condition, in which the spleen is located in other than the left upper quadrant of the abdomen. The clinical manifestation is variable from asymptomatic to abdominal catastrophy due to torsion of the splenic pedicle. We experienced a case of torsion of wandering spleen in 8-year-old girl who admitted with fever, vomiting, abdominal pain, palpable left abdominal mass. She was diagnosed preoperatively with the aid of abdominal sonography and C.T. scanning. A splenectomy was performed and she made uneventful recovery. The case report illustrates some of the diagnostic and therapeutic considerations pertaining to wandering spleen with a brief review of related literature.
Abdomen ; Abdominal Pain ; Child ; Female ; Fever ; Humans ; Spleen ; Splenectomy ; Vomiting ; Wandering Spleen*