Pretibial myxedema is a condition in which there is loeal thickening of the skin by a mucin-like deposit; it is nearly always asosciated with ophthalmopathy and thyrotoxicosis, not infrequently becomes more pronounced after treatrnent of thyrotoxicosis. The precise cause of pretibial myxedema is not known, but it appears that IgG LATS represents an autoantibody against a thyroid antigen, retroorbital tiesue and tbe skin, so, pretibial myxedema is presumed to be the result of a local antigen-antibody tissue reaction. A 57-year-old man had the history of diabetes since 1964 and Graves disease since May 1980, he was treated with metimazole for 1 month, with improving thyrotoxicosis but developed the pretibial myxedema. The histologic findings showed considerable amount of mucin, especially hyaluronic acid with toluidin blue stain at PH 3.0. The lesions were improved by local application of 0.01 x fluocinolone acetonide ointment with occlusive dressing technique.
Fluocinolone Acetonide ; Graves Disease ; Humans ; Hyaluronic Acid ; Hydrogen-Ion Concentration ; Immunoglobulin G ; Long-Acting Thyroid Stimulator ; Middle Aged ; Mucins ; Myxedema* ; Occlusive Dressings ; Skin ; Thyroid Gland ; Thyrotoxicosis

BACKGROUND: HBsAg carriers are 6-12% of population in Korea. The patients knowledge on hepatitis B and regular follow-up tests are important, because HBsAg carriers have infectivity and the disease may progress without symptoms. We surveyed their knowledge on the hepatitis B and the frequency of follow-up blood test and sonogram. METHODS: From March 1993 through September 1994, 630 patients who were diagnosed as HBsAg positive and Anti-HBs negative in a health promotion center of college hospital were surveyed by mailing questionnaire. The questionnaire included the result of HBV viral marker test, transmission routes, complications, and prevention methods of Hepatitis B, frequency of follow-up test, and doctors recommendation. RESULTS: Of the 490 questionnaires excluded the 140 questionaires returned due to wrong address, 100 were answered, making the reply rate 20.4%. As for the result of HBV marker test, 64% answered their HBV marker as HBsAg positve, 10% answered HBsAg negative, and 26% answered I dont know. 65% answered that they are HBV carrier. As for the mode of transmission, 59% answered that HBV is transmitted by blood, 57% from carrier mother at birth, 29 % by sexual intercourse. 76% of responders know that vaccination is needed for preventing vertical transmission. When making score on their knowledge, significant differences were showed according to education, income and doctors recommendation about regular follow-up test. The number of persons who took regular blood test every 6 to 12 months were 56(56%), and the number of persons who took regular abdominal ultrasonogram were 39(39%). The number of patients who were recommended regular follow-up by doctor was 76%. In this group, 51 persons(67.0%) took regular blood test and 35 persons(35%) took regular sonogram so this frequency is significantly higher than the other group(each 20.8%, 16.7%). CONCLUSIONS: The knowledge on hepatitis B in HBsAg positive patients is relatively low and the frequency of regular follow-up test is significantly higher in the group who took doctors recommendation. So it is very important that HBsAg carriers must be educated about the infectivity, preventive methods, and regular follow-up for early detection of complication like hepatocellular cancer.
Biomarkers ; Coitus ; Education ; Follow-Up Studies* ; Health Promotion ; Hematologic Tests ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Liver Neoplasms ; Mothers ; Parturition ; Postal Service ; Ultrasonography ; Vaccination ; Surveys and Questionnaires

BACKGROUND: Direct laryngoscope may be less useful under conditions of limited visualization. Light wand is a lighted stylet to transilluminate neck tissues allowing intubation without visualization. Thus, difficult intubation due to anatomy can be overcome. For comparison of light wand and direct laryngoscope, we checked time to intubation (TTI), success rate, relation of TTI and thyromental distance (TMD), and change of blood pressure and heart rate after intubation. METHODS: We selected and randomly allocated sixty adults to direct layngoscope group (D) and light wand group (L). Without premedication, propofol and vecuronium were injected for intubation. Time to intubation was measured from the time of grasping direct laryngoscope or light wand until the time of inserting endotracheal tube into trachea. We checked the change of blood pressure and heart rate after intubation, and studied the correlation of TTI and TMD. RESULTS: TTI was 16.5 sec (6.53~115.3 sec) for group D and 11.8 sec (4.31~36.0 sec) for group L. There was no significant difference between the groups. The rise of blood pressure and heart rate was less with light wand. There was a correlation of [TTI]=1248- 388[TMD]-30[TMD]2 in group L patients whose TMD is less than 7 cm. CONCLUSION: Compared with direct laryngoscope, light wand is as easy to use and can be more effective especially for patients whose anatomy may make intubation difficult or whose cardiovascular system is unstable.
Adult ; Blood Pressure* ; Cardiovascular System ; Hand Strength ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Neck ; Premedication ; Propofol ; Trachea ; Vecuronium Bromide

BACKGROUND: Direct laryngoscope may be less useful under conditions of limited visualization. Light wand is a lighted stylet to transilluminate neck tissues allowing intubation without visualization. Thus, difficult intubation due to anatomy can be overcome. For comparison of light wand and direct laryngoscope, we checked time to intubation (TTI), success rate, relation of TTI and thyromental distance (TMD), and change of blood pressure and heart rate after intubation. METHODS: We selected and randomly allocated sixty adults to direct layngoscope group (D) and light wand group (L). Without premedication, propofol and vecuronium were injected for intubation. Time to intubation was measured from the time of grasping direct laryngoscope or light wand until the time of inserting endotracheal tube into trachea. We checked the change of blood pressure and heart rate after intubation, and studied the correlation of TTI and TMD. RESULTS: TTI was 16.5 sec (6.53~115.3 sec) for group D and 11.8 sec (4.31~36.0 sec) for group L. There was no significant difference between the groups. The rise of blood pressure and heart rate was less with light wand. There was a correlation of [TTI]=1248- 388[TMD]-30[TMD]2 in group L patients whose TMD is less than 7 cm. CONCLUSION: Compared with direct laryngoscope, light wand is as easy to use and can be more effective especially for patients whose anatomy may make intubation difficult or whose cardiovascular system is unstable.
Adult ; Blood Pressure* ; Cardiovascular System ; Hand Strength ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Neck ; Premedication ; Propofol ; Trachea ; Vecuronium Bromide

Autonomic dysreflexia is a syndrome characterized by severe hypertension, headache, sweating that is seen in spinal cord injury population. It can be a life-threatening problem if not promptly recognized and treated. Since the most common cause is bladder distention, it is essential that the urologist sh6fild be familiar with this syndrome. Two hundred ninety four patients with spinal cord injury were reviewed for the prevalence rate and clinical manifestations of autonomic dysreflexia. The time of onset post-injury, precipitating causes, presenting symptoms and management were analyzed. 42 patients (34.4%) of 122 patients with lesion above T6 level exhibited autonomic dysreflexia. The majority of patients (61.9%) had manifested signs and symptoms of autonomic dysreflexia within the first year. The precipitating causes were bladder distention (69.0%), bowel distention (23.8%) and urinary tract infection (7.1%). The presenting symptoms of autonomic dysreflexia were headache (88.1%), sweating (88.1%), hot flushing (28.6%), chest discomfort, hyperpnea and spasm. The management of autonomic dysreflexia include prompt bladder erupting, bed rest and appropriate bowel preparation. In conclusion, prompt recognition and appropriate management of autonomic dysreflexia are essential to prevent life-threatening sequelae.
Autonomic Dysreflexia* ; Bed Rest ; Flushing ; Headache ; Humans ; Hypertension ; Prevalence ; Spasm ; Spinal Cord Injuries* ; Spinal Cord* ; Sweat ; Sweating ; Thorax ; Urinary Bladder ; Urinary Tract Infections

BACKGREOUND: Cerebral damage caused by hemorrhagic shock presents an important challenge for critical care medicine. The type of fluid to resuscitate hemorrhagic shock is important for the outcome of such patients. Pentastarch is low-molecular-weight hydroxyethyl starch, which increases cerebral blood flow (CBF) by plasma volume expansion and compensatory vasodilation, and improves the microcirculation in the ischemic brain area by reducing the blood viscosity. METHODS: The authors continuously determined CBF and CMRO2 in 10 mongrel dogs weighing 20.1 +/- 0.8 kg with posterior sagittal sinus outflow method. Dogs were subjected to the 20 minute-period of hemorrhagic shock to a mean arterial pressure of 40 mmHg. The shock phase was followed by resuscitation with the same volume of 10% pentastarch as blood loss. The authors assessed the changes of CBF, CMRO2, and CBF/CMRO2 ratio immediately and 30, 60, 90, 120 minutes after pentastarch infusion. Brain water content was assessed by the wet-dry weight method. RESULTS: CBF was increased above the control level, immediately and 30 minutes after 10% pentastarch infusion (p<0.05), and approximated to the control level for the remaining time. CMRO2 was increased, immediately and 30, 60, 90 minutes after 10% pentastarch infusion (p<0.05), and approximated to the control level at 120 minutes. CBF/CMRO2 ratio was recovered to the control level after 10% pentastarch infusion. Brain water content was not significantly different from the normal value of dogs. CONCLUSION: 10% pentastarch may be used with safety to resuscitate hemorrhagic shock because it recovers the balance between the cerebral oxygen supply and demand, and does not cause cerebral edema.
Animals ; Arterial Pressure ; Blood Viscosity ; Brain ; Brain Edema ; Critical Care ; Dogs ; Humans ; Hydroxyethyl Starch Derivatives* ; Microcirculation ; Oxygen* ; Plasma Volume ; Reference Values ; Resuscitation ; Shock ; Shock, Hemorrhagic* ; Starch ; Vasodilation

PURPOSE: A survey was performed to identify the level of mouthguard use, awareness, wearability issues and attitude toward mouthguard among elite Korean Taewondo athletes. MATERIALS AND METHODS: Survey questionnaires were given to 152 athletes participating in the Korea National Taekwondo team selection event for the 2010 Guangzhou Asian Games. Questionnaires consisted of three sections, mouthguard awareness, reasons for not wearing mouthguard and the last section to test the level of acceptance on current mouthguard and when the identified problems were resolved. For analyzing difference among response, chi2 test was used and significant level (alpha) was set up as 0.05. RESULTS: Responses in each of items showed significant difference (P<.001). Majority of response regarding each question: Majority of respondents believed that mouthguard were effective in preventing injuries (36.4%) but the result suggested that the provision of information on mouthguard to athletes was inadequate (44.0%) and the result showed that respondents were not greatly interested or concerned in relation to the mandatory mouthguard rule (31.6%). Although the responses on the level of comfort and wearability of mouthguard were negative (34.8%), athletes were positively willing to wear mouthguard if the problems rectified (51.2%). CONCLUSION: Considering the high level of willingness to wear mouthguard if the problems rectified, it is thought that together with efforts in providing more mouthguard information, the work of sports dentistry to research and improve mouthguard will be invaluable in promoting mouthguard to more athletes.
Asian Continental Ancestry Group ; Athletes ; Dentistry ; Humans ; Korea ; Martial Arts ; Mouth Protectors ; Sports ; Surveys and Questionnaires

BACKGROUND: Parent's alcohol drinking not only influences their health but also their children. This research was designed to assess the family function of children who were affected by parent's alcohol drinking. METHODS: Questionnaire survey was performed on 208 high school students (129 males and 79 females) in Daejeon from March to April, 2005. We defined the students whose CAST (Children of Alcoholics Screening Test) score was 6 or more as children of alcoholics (COA) group. Then, we evaluated the family function by family APGAR score between the COA group and the control group. RESULTS: Among the total, 36 (27.9%) male and 27 (34.1%) female students were in COA group. There was a significant (P<0.01) negative correlation between the CAST score and the family APGAR score in all students. In boys, there was no significant correlation between the CAST score and the family APGAR score, but in girls, there was significant negative correlation (P<0.01). Mean family APGAR score of the COA group was significantly (P<0.05) lower than that of the control group in all students. In boys, there was no significant difference, but in girls, the COA group's family APGAR score was significantly lower than the control group's score (P<0.05). CONCLUSION: The high school students, especially girl students, who were affected by parent's alcohol drinking showed a lower family APGAR score. Therefore, family physicians need to evaluate the family function when encountering students similar to COA group.
Alcohol Drinking ; Alcoholics* ; Apgar Score ; Child* ; Female ; Humans ; Male ; Mass Screening* ; Physicians, Family ; Surveys and Questionnaires

PURPOSE: To evaluate the usefulness of CT features of appendiceal mucocele in the diagnosis and evaluation of complications. MATERIALS AND METHODS: We retrospectively reviewed CT findings and compared with operative findings in 7 cases of pathologically proven appendiceal mucocele. CT findings such as location and extent of the lesion, Issue density, thickness or calcification of the wall, presence of adjacent inflammatory infiltration, and visualization of normal vermiform appendix were analyzed. RESULTS: Appendiceal mucocele was found as homogeneous low density cystic mass adjacent to the cecum, which has no surrounding inflammatory infiltration except in one case of perforation and one case of intussusception. Mean CT number measured in 4 cases was 21 Hounsfield unit. Thin curvilinear calcifications were noted along the cystic wall in 2 cases. Normal vermiform appendix couldn't be demonstrated in all cases. CONCLUSION: Appendiceal mucocele is characterized by homogeneously low density and thin walled cystic tumor adjacent to cecum without surrounding inflammatory infiltration, and absence of normal vermiform appendix on CT. Therefore, CT is valuable in preventing operative complications of appendiceal mucocele.
Appendix ; Cecum ; Diagnosis ; Intussusception ; Mucocele* ; Retrospective Studies

No abstract available.
Animals ; Female ; Horns* ; Humans ; Uterus*