No abstract available.
Bronchiolitis* ; Respiratory Sounds*

BACKGROUND: Recently preventive clinical care has been proved important to the health. A number of recommendations or programs for preventive health services have been developed. The government made laws for health promotion of the people and for medical check-up for the insured in the district medical insurance association, who had been alienated from reimbursement for periodic health examination. As a result, above 95% of Korean people could took the periodic health check-up by this legislation. According to the national data, however, about 20% of the insured participated in the health screening program which was carried for the first time by the district medical insurance association in 1995. The reason that the compliance of health screening program was much lower than expected has not been clear yet. The purpose of this study is to define the facors affecting on the compliance of the health screening program. METHODS: Two hundreds of compliers and as many non-compliers of the health screening program was selected by the stratified sampling in one district medical insurance association which consisted of one town and eight township within the National Capital region. The telephone survey was performed from June 1 to 15 in 1996. The questionnaire was framed by health belief model with other demographic data. The data was analyzed by chisquare test, wilcoxon rank sums test, and logistic regression for the comparison of the characteristics between compliers and non-compliers. RESULTS: There was no difference of demographic data and medical history of chronic disease between compliers and non-compliers. 73.3% of the subjects knew they had been the expectant examinee of the health examination, and among them, 68% took the health examination. However, 53% of non-compliers did not know that they had been the expectant examinee. The most common reason that non-compliers didnt took the health examination was they didnt know(43.5%). Among 73 families of compliers which had more than 2 expectant examinees of the health screening program, 44 families(60.3%) had more complier other than study subjects. In contrast, among 74 families of non-compliers, only 7 famiies(9.5%) had more complier other than study subjects. Compliers showed lower reliability of the health screening program than non-compliers. Non-compliers had more perception about the severity of the target disease for the examination and had more confidence about self health status than compliers. There was no difference of the answer about the benefit of the health examination, perceived susceptibility about target disease, cue to action, and perceived barriers. The odds ratio of compliance of other family member was 21.2, perceived severity, 0.70, and cue to action, 1.36. CONCLUSIONS: The main reason of low compliance of health screening program for the insured in the district mecical insurance association was lack of public information. By the fact that non-compliers had more perception about the severity of the target disease and there was no difference of perceived benefit of the health examination between two groups, public information should be focused on the benefit and efficacy of periodic health check-up than severity and susceptibility of target disease. Because the health screening program on study subjects was carried for the firt time, only compliers had experience of the examination. The fact that compliers relied on the examination less than noncompliers meant that the examinees was satisfied much less than expected. Therefore, further study of the expectation of the examinees about the health examination is expected.
Chronic Disease ; Compliance* ; Cues ; Emigrants and Immigrants ; Health Promotion ; Humans ; Insurance* ; Jurisprudence ; Logistic Models ; Mass Screening* ; Odds Ratio ; Preventive Health Services ; Telephone ; Surveys and Questionnaires

Neuromyelitis optica (Devic`s syndrome) is a rare demyelinating disorder of unknown etiology in which unilateral or bilateral optic neuritis and transverse myelitis occur within an 8-week time interval. It is 8 disorder that occurs more common in children than in adults. The prognosis is better in children than in adults. The authors experienced 8 case of neuromyelitis optica in a 5-year-old female who developed acute visual loss of the left eye, sensory loss below the 4th thoracic derinatoine, paraplegia, fever and nuchal ridigity ; all following viral prodromes. We diagnosed this case through neurologic features, magnetic resonance imaging, and cerebrospinal fluid findings. She has irnproved without any specific treatment.
Adult ; Cerebrospinal Fluid ; Child* ; Child, Preschool ; Demyelinating Diseases ; Female ; Fever ; Humans ; Magnetic Resonance Imaging ; Myelitis, Transverse ; Neuromyelitis Optica* ; Optic Neuritis ; Paraplegia ; Prognosis

No abstract available.
Pancreatitis, Chronic*

The purpose of this study is to evaluate the results of primary repair and autogenous tendon augrnentation for acute rupture of anterior cruciate ligament. We primarily repaired 13 cases of acute ACL injury with autogenous tendon augmentation between Jul. 1988 and Jan. 1996. Among 13 cases, there were 2 isolated ACL injuries and 11 cases were combined with MCL injuries. All 13 cases were followed up over 1 year. An average follow up period was 4.1 years (1.1 - 8). All patients had open primary rnultiple suture repair and semitendinosus tendon (11 cases) or iliotibial band (2 cases) augmentation at average 3.6 days after the injury. In 11 cases, medial collateral ligarnent injuries were noted and these ruptured ligaments were supplemented with staple or vicryl suture. We evaluated the results with Lysholm Knee Score, KT-1000 arthrometer, postoperative ROM of knee, thigh muscle atrophy, extension lag, Lachman and pivot shift test. The clinical results were as follows 1. Lysholm Knee Score was mean 87.2 points; over 90 points: 5 cases, 80-8$ points: 5 cases, 70-79 points: 3 cases 2. Using the KT-1000 arthrometer, the average side to side difference wm 1.8nun in 201b (89N) and the compliance index was average 1.7mm. 3. Postoperative ROM of knee was nearly normal and there was no extensioe lag in any cases. But, we performed arthroscopic adhesiolysis in one case for limited motion of knee joint a ( postoperative 8 months. Thigh circumference was measured 0.95 cm difference than the healthy side at 10cm above upper pole of patella. 4. Lachman test was positive in 2 cases. 5. Pivot shift test was positive in 2 cases. Even if not many cases, we obtained relatively satisfactory results. So the pirimary repair with autogenous tendon auynentation was recornmandable procedure for acute rupture of ACL, especially combined with MCL injury.
Anterior Cruciate Ligament ; Compliance ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Muscular Atrophy ; Patella ; Polyglactin 910 ; Rupture ; Sutures ; Tendons* ; Thigh

In shape and dimensions, the tibial plateaus are asymmetric with the larger medial tibial plateau and both have a posterior inclination with respect to the shaft of the tibia. Maximizing tibial coverage is an impotant consideration in total knee arthroplasty to provide stahility and load transfer and to improve long-term survival rate of the implants. Most tihial tray designs are symmetric, but several asymmetric designs are available. We evaluated the proximal tibial resection surface during total knee aithroplasty to delineate the tibial plateaus in korean. After tihial bone cut during 100 TKA procedures, the outline of tibial resection suiface was traced and rotational axis of true tibial component was marked intraoperatively. A line was drawn at the maximal anteroposterior (AP) diameter of lateral tibial condyle with parallel to rotational axis of component, and then a transverse axis was drawn at the midpoint of maximal AP diameter of 1ateral tibial condyle. Anteroposterior 10, 20, 30., 40% and midpoint from the media1 and lateral peripheries were calculated manually. The average AP medial 10, 20, 30 and 40% dimensions were 34.7, 43.8, 48.0 and 43.2mm, respectively. The average AP lateral 10, 20, 30 and 40% dimensions were 30.2, 38.4, 42.0 and 40.9mm, respectively. The ratio of medial/lateral AP dimensions 10, 20, 30 and 40% from periphery were 116.9, 114.7, 114.5 and 106.4%, respectively. From these data, we know the asymmetry of the proxirnal tibia1 plateaus in korean. We hope that rnore data will be ohtained in multicenter studies and it will help us to select tibia1 tray and to design the tibial component in korean. But, more accurate standard measures will he need to minimize an error of measurements.
Arthroplasty* ; Axis, Cervical Vertebra ; Hope ; Knee* ; Survival Rate ; Tibia

We report two cases of angiokeratoma circumcriptum. One of them was 20 year- old male, who had multiple dark erythematous 0.5 cm to 2 cm sized keratotic papules and nodules surrounding irregular shaped erythema scattered or grouped on the right lower leg. The other case was 36 year-old male, who had Q. 7 cm sized dark erythematous papules and 2 cm sized dark brown colored nodule with central ulceration on the medial part of the left upper thigh, The two patients had skin lesions at birth. Histopathologic finding disclosed markedly dilated vessels containing many red blood cells mainly in the papillary dermis, which in some, were surrounded by elongated rete ridge. Cavernous hemangioma like lesion was present in the lower dermis and subcutaneous fat in case 2.
Adult ; Angiokeratoma* ; Dermis ; Erythema ; Erythrocytes ; Hemangioma, Cavernous ; Humans ; Leg ; Male ; Parturition ; Skin ; Subcutaneous Fat ; Thigh ; Ulcer

BACKGROUND: Women with end-stage renal disease have low fertility. Following renal transplantation, the reproductive function returns to normal, and pregnancy becomes possible. METHOD: At our medical center, between June 1990 and February 1998, 263 female patients underwent renal transplantations, and 14 of them later became pregnant. The outcomes from 23 pregnancies in these 14 kidney transplant recipients were analyzed. RESULT: Forty-three percent (43%) of the pregnancies ended in artificial (9 cases) or spontaneous abortion (1 case), and 11 of 13 deliveries were successful. A vaginal delivery was performed in 9 cases (69%) and a cesarian section was done in 4 cases (31%). All of the 11 pregnancies that continued over 30 weeks ended successfully. The mean age of the recipients at the first pregnancy was 29.4 +/- 4.6 years (23-37). The mean time to first pregnancy since renal transplantation was 22.6 +/- 12.3 months (1-50). Thirteen (13) recipients were maintained on cyclosporin-based immunosuppressive regimens before and during pregnancy. One recipient, who was considered to have developed immune tolerance later, stopped the immunosuppressive drug at 3 months prior to the first pregnancy. The renal function remained stable and unchanged in all the recipients, and no rejection episodes occurred during and after pregnancy in any of the recipients. Preeclamsia occurred in 8 cases (35%) and a previous rupture of membrane in 1 case (4%). Of the 11 live births, 4 (36%) were premature (<37 weeks), 1 (9%) had a lowbirth-weight (<2500 gm), 1 (9%) had transient apnea, and 3 (27%) had transient neutropenia. The mean Apgar score at 1 minute was 7.8 (7-9), with only 2 children having a score below 7. No congenital anomalies were documented. The later development and health of all of the children were good during a mean follow-up of 16.6 +/- 10 (1-38) months. Two (2) recipients who had a successful first pregnancy had a second baby. CONCLUSION: From these results, we can conclude that pregnancy does not adversely affect graft function and fetal development, provided that the graft function was stable at the time of conception and prudent fetal monitoring could be done.
Abortion, Spontaneous ; Apgar Score ; Apnea ; Child ; Female ; Fertility ; Fertilization ; Fetal Development ; Fetal Monitoring ; Follow-Up Studies ; Humans ; Immune Tolerance ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Live Birth ; Membranes ; Neutropenia ; Pregnancy* ; Rupture ; Transplantation ; Transplants

BACKGROUND: In South Korea, indigenous malaria has been reappeared since 1993 and more than 350 cases diagnosed in 1996. For the diagnosis of malaria the classic methods such as thin and thick blood smears with Giemsa or Wright stain has been routinely used. Since recently fluorochrome staining has been shown to be more sensitive, easy to do, and less time-consuming, we applied the new method, Acridine orange stain, for diagnosis of clinically suspected cases. METHODS: Thin and thick blood smears were prepared from civilian patients of Kyunggi Province (n=20) and Republic Of Korea army patients pre- (n=67) and post-treatment (n=13) of malaria. The slides were fixed by methanol and stained by either Giemsa or Acridine orange solution (10-50 g/mL). For comparison, an expert on malaria diagnosis examined them by light and fluorescent microscope, respectively. RESULT: Acridine orange stain was found to be a rapid technique, and as sensitive (83%) as thick smears (83%) for diagnosis of malaria. The detection limit of acridine orange stain was 23.5 parasites/ul of blood. The staining time was much shorter (30 sec) than that of Giemsa stain (30-60min). CONCLUSION: Acridine orange stain is evaluated as a simple, rapid, and sensitive method for malaria diagnosis compared with Giemsa stain.
Acridine Orange* ; Azure Stains ; Diagnosis* ; Gyeonggi-do ; Humans ; Korea ; Limit of Detection ; Malaria* ; Methanol ; Republic of Korea

A 26-year-old woman had an ovarian Sertoli-Leydig cell tumor (SLCT) associated with an elevated level of serum alpha-fetoprotein (AFP). The tumor had a heterologous element of intestinal-type mucinous epithelium, retiform and intermediately differentiated tubules of the Sertoli cells, and AFP-producing Leydig cells. AFP was demonstrated within the Leydig cells by an immunohistochemical technique. After surgery, the serum AFP level of the patient fell to the normal range. The present case is the first documented case of AFP producing a SLCT of the ovary reported in Korea.
Adult ; alpha-Fetoproteins* ; Epithelium ; Female ; Humans ; Korea ; Leydig Cells ; Male ; Mucins ; Ovary* ; Reference Values ; Sertoli Cells ; Sertoli-Leydig Cell Tumor*