The author observed clinical study and response of -interferon treatment of 43 cases of chronic hepatitis who were admitted to Department of Pediatrics Pusan National University College of Medicine during the period of 4 year 6 months from Jenuary, 1988 to Jun, 1992. The results were as follows: 1) Of 43 patients with chronic hepatitis, CPH was 17 cases (39.5%) and CAH was 26 cases (60.5%). 2) Of 43 patients, chronic hepatitis caused by HBV was 37 cases (86.0%) 2 cases were by Wilson's disease, 1 case was by glycogen storage disease and in the 3 cases, the cause was undetermined and CPH by HBV and CAH were 14 cases (82.4%), 23 cases (88.5%) respectively. 3) A peak frequency (46.5%) of chronic hepatitis occurred between 6 to age and male predominated in a propotion of 3.5:1. 4) On the clinical manifestation, jaundice and hepatomegaly was higher frequency on CAH than on CPH. 5) On the laboratory findings, CAH had higher serum ALT and direct bilirubin level than CPH. 6) On effect of -interferon treatment for patients of CAH, serum ALT and AST levels normalized in 81.8% of patients, negative conversion of HBeAg was 38.5%, Anti-HBe serocoversion was 7.7%, negative conversion of HBsAg was 7.7% and the clearnce of HBV-DNA from seum showed 60.0%. 7) The HBeAg seroconversion (28.6%) on children of HBsAg(+) mother showed lower reponse than HBeAg seroconversion (50.0%) of HBsAg(-) mother after -interferon treatment for patients of CAH.
Bilirubin ; Busan ; Child* ; Glycogen Storage Disease ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Hepatolenticular Degeneration ; Hepatomegaly ; Humans ; Jaundice ; Male ; Mothers ; Pediatrics

Solar urticaria is a fairly uncommon but Well recognized clinical entity characterized by erythema and wheal with itching immediately following exposure to sunlight or artifical radiation. A 33-year-old female had a six-year duration of urticaria, tightness of chest and dizziness that appeared within 15 minutes of exposure to sunlight. The action spectrum of this patient was between 320 and 400nm and the passive and reverse passive transfer test were negative. Solar urticaria of our patient appeared to belong to type g in the classification of Harber et al(1963). The patient was treated with antihistamines and repeated exposure to sunlight for inducing tolerance. After 3 months of the treatment, the symptoms did not appear even after 3 hours of exposure to sunlight.
Adult ; Classification ; Dizziness ; Erythema ; Female ; Histamine Antagonists ; Humans ; Intradermal Tests ; Pruritus ; Sunlight ; Thorax ; Urticaria*

No abstract available.
Acne Vulgaris* ; Isotretinoin*

A case of scabies combined with superficial dermatophytosis which was aggravated by application of topical fluorinated steroid for 6 months is presented. One year ago a 60-year-old male began to have pruritic erythematous papules on the lower abdomen which spread slowly to the inguinal and buttock area. He had had onychomycosis for six years and for the last 6 months he had applied a. fluorinated steroid. preparation. After application of steroid, the aggravated skin lesions spread rapidly over the whole body. A KOH mount showed sarcoptes scabiei and fungus. A count of itch mites from scales brushed off and collected from. the overall surface of the patients body showed 263 adults, 169 Iarvae and 534 eggs. T. rubrum from a culture of scales from the trunk and nails was confirmed. On admission FBS and oral GTT test revealed diabetic curve, however it could not be determined whether the diabetes mellitus was primary or secondary to the use of topical steroid application. The patient has been treated with crotamiton cream and antifungal agent with remarkably effective results.
Abdomen ; Adult ; Buttocks ; Diabetes Mellitus ; Eggs ; Fungi ; Humans ; Male ; Middle Aged ; Mites ; Onychomycosis ; Ovum ; Sarcoptes scabiei ; Scabies* ; Skin ; Tinea* ; Weights and Measures

We observed 2 cases of multiple trichoepithelioma, which occured in 25-year- old male and 20-year-old female. They visited our department for multiple skin rashes on the face of 8 years duration in male and 7 years' duration in female patient. Both of them have similar skin lesions characterized by multiplel waxy gshiny, skin colored, firm papules scattered on the nasolabial folds, both eyelids and forehead. Each one of them has a history of similar skin lesions in the family. Literatures are briefly reviewed for discussion of clinical and histopathologicl findings in this disease.
Exanthema ; Eyelids ; Female ; Forehead ; Humans ; Male ; Nasolabial Fold ; Skin ; Young Adult

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.
Adult ; Autopsy* ; Diabetic Ketoacidosis* ; Diagnosis ; Female ; Heart* ; Humans ; Hypertriglyceridemia* ; Korea ; Plasma ; Postmortem Changes

OBJECTIVES: Salmonellosis is one of the most common bacterial infections in the Korea. The incidence of salmonellosis has changed dramatically. The incidence of typhoid fever tends to decrease as environmental & personal sanitations improve, whereas that of nontyphoid salmonellae have markedly increased. Antimicrobial resistance is increasing in Salmonella strains. Increasing emergence in multiple-drug resistant Sallmonella strains has important clinical & public implications for populations at risk and the treatment of invasive salmonellosis is complicated by the increasing resistance among Salmonella strains to commonly used antimicrobial agents. This study is performed to fine out the pattern and the antimicrobial susceptibility of isolated Salmonella strains and the clinical charateristics of Salmonella infection. METHODS: We reviewed medical records of all patients with culture-confirmed Salmonella infection in Kyung Hee University Hospital for the period January 1987 through December 1995. RESULTS: 1) The mean age of the patients was 31.0 years and the ratio of male to female was 1.03:1. 2) The frequency of isolation of specific serogroups is ordered as followings : serogroup B(47.9%), serogroup D(23.3%), S. typhi(16.2%), serogroup C(9.6%), serogroup E(1.8%), serogroup A(1.2%). 3) The sites of isolation were as follows : stool(68.6%), blood(24.0%), pus(3.5%), urine(2.2%), bone marrow(2.2%), bile juice(0.4%), ascites(0.4%), CSF(0.2%), sputum(0.2%). 4) The isolation rate of resistant strains of specific serogroups was as follows in order : serogroup B(52.4%), serogroup C(33.3%), serogroup E(25%), serogroup D(9.8%), S. typhi(4.2%), serogroup A(0%). 5) The frequency of animicrobial resistance in Salmonella strains to tested 8 antimicrobial agents was as follows : ampicillin(28.8%), carbenicillin(28.1%), chloramphenicol(16.4%), kanamycin(5.9%), trimethoprim-sulfamethoxazole(5.3%), cephalothin(2.3%), gentamicin(0.9%), amikacin(0.5%). 6) The most of antimicrobial-resistant Salmonella(95.0% of resistant strains) has multiple drug resiatance. 7) The frequency of clinical manifestations of nontyphoid salmonellosis was as follows : enterocolitis(80.1%), bacteremia without focal infection(13.1%), focal infection(6.8%). 8) The clinical variables statistically significant between resistant and sensitive Salmonella infection are frequency of bacteremia and duration of admission. CONCLUSION: Different serogroups of Salmonella isolates reveal the different frequency & pattern in antimicrobial resistance. The frequency of antimicrobial resistance for Salmonella isolates is markely increased during recent 9 years. In preparation for the future outbreaks of multiresistant sallmonellosis, nationwide studies should be carried out periodically to monitor effectively trends in the antimicrobial resistance of Salmonella and the development of effective and practical alternative therapy for resistant salmonellosis is clearly needed.
Anti-Infective Agents ; Bacteremia ; Bacterial Infections ; Bile ; Disease Outbreaks ; Female ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Population Characteristics ; Salmonella Infections* ; Salmonella* ; Typhoid Fever

OBJECTIVES: To determine the prevalence, pattern, and out-of-pocket expenditure of complementary and alternative medicine (CAM) utilization in Korean adult population. METHODS: We conducted a representative telephone survey of 2,042 persons aged 18 or older. Data about any health problem, details of their use of medical doctors(MDs) offices/hospitals/ pharmacies services and CAM during the preceding 12 months were collected with structured questionnaire. RESULTS: The utilization rate of CAM among Korean adults was 29% in one year. A total of 231 kinds of CAM was identified from this survey. Annual out-of-pocket expenditure associated with CAM use in 1998 amounted to pound $1.88 billion and was comparable to 40.8% of out-of-pocket expenditure paid for MDs offices/ hospitals/pharmacies services. Among those(N=424) who paid for both MDs offices/hospitals/pharmacies services and CAM, 35.8% paid more for CAM. CAM gave more satisfaction than western medicine to those who had experience of both types of therapy. About half of CAM users were willing to recommend CAM to others. Disclosure rate to physician among CAM users was not high(40.6%). CONCLUSION: CAM became a popular source of health care in Korea. Korean spent a substantial amount of out-of-pocket money on CAM without any public control. Because CAM use is likely to be increased rapidly through lay referral system, health policy makers and health professionals should pay more attention to CAM for making appropriate utilization of CAM.
Adult ; Complementary Therapies* ; Delivery of Health Care ; Disclosure ; Health Expenditures* ; Health Occupations ; Health Policy ; Humans ; Korea* ; Pharmacies ; Prevalence* ; Surveys and Questionnaires ; Referral and Consultation ; Telephone

The hemodynamic feature of the tetralogy of Fallot (TOF) is best characterized by equality of left and right ventricular peak systolic pressure. The interventricular septum is flattened and thickened. Even after the right ventricular pressure is normalized in the postoperative period, the morphological abnormality continues for some time We have analyzed the morphological changes of the IVS echocardiographically after total correction and tried to correlate them with the prognosis of the patients. Forty five patients underwent total correction of TOF between May 1991 and July 1992.The IVS morphology was assessed with 2-D echocardiography before and after surgery. The control group consisted of 15 normal subjects(8 with functional cardiac murmur and 7 with non-cardiac diseases).We also evaluated the influence of the residual pulmonary regurgitation(PR) or pulmonic stenosis (PS) upon sequential changes in the end-systolic configuration and the thickness of the IVS. The following results were obtained. 1) Four months after total correction the IVS thickness and configuration at end-systole of the study patients were normalized, and they were not significantly different compared to those of the control group. 2) The postoperative residual PR of mild to moderate degree did not influence the course of morphological normalization. On the other hand, the postoperative residual PS greater than moderate degree hindered the normalization process. And the morphological abnormalities in the patients with the residual PS lasted longer than in the patients with the residual PR. 3) It would be necessary to perform cardiac catheterization in order to evaluate and to take care of the residual hemodynamic abnormalities if the IVS morphology remains to be abnormal even after one year after total correction.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Hand ; Heart Murmurs ; Hemodynamics ; Humans ; Postoperative Period ; Prognosis ; Pulmonary Valve Stenosis ; Tetralogy of Fallot* ; Ventricular Pressure