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*

No abstract available.
Peanut Hypersensitivity

BACKGROUND: Nowadays, as public awareness of t,he Acquired immunedeficiency syndrome(AIDS) epidemic was increasing, athletes have become more concerned about their risk of infection with human immunedeficiency virus(HIV) since it, was announced that Magic Johnson, hero of basketball in the United States, was infected. Because there are no exact cure method about AIDS, the only treatment is prevention through the education and awareness of AIDS. Therefore, we researched the athletes knowledge of AIDS to provide the b#asis of preventive methods. METHODS: A questionnaire was given directly to the 110 wrestling and taekwondo athletes attending a sports college. RESULT: Athletes are all men and their mean age is 24.6 years old. Concerning the question of latent period, 54.5% had correct answer that AIDS development took more than several years after HIV infection. The person who had educated about the preventive methods of infection during the sports was 4.6%. The person who answered AIDS athletes should be excluded from the sports was 64.5% and the reason of exclusion was the risk of infection through the small bleeding(49.8%), sweating(38.0%), and simple skin cont,acts(19. 7%) during the sports. The correct recognition rate of preventive method of infection during the sports was 51.8 to 62%. Concerning the risk routes and behaviors of infection during daily life, most of them recognized correctly(from 76,3% to 99.0% by each item), but some have also misconception about transfusion(61.0%), skin contact(33%) and mosquitos bite(30%) etc. CONCLUSION: Almost all of athletes recognized correctly the risky behavior of sex and blood in transmission of infection, but some have also misconception in daily activities, e.g. transfusion and mosquitos. Many persons answered AIDS infected athletes should be excluded from the sports and they didnt receive any education about preventive methods of AIDS infection during the sports. The knowledge of preventive methods of infection recommended during the sports was relatively high.
Athletes* ; Basketball ; Culicidae ; Education ; HIV Infections ; Humans ; Korea* ; Magic ; Male ; Skin ; Sports ; United States ; Wrestling ; Surveys and Questionnaires

PURPOSE: Parenchymal iron deposition occurs in hemochromatosis, while iron is deposited in reticuloendothelial cells after blood transfusions(Hemosiderosis). We stuided correlation between MR finding and clinical findings(serum ferritin, TSI, LFT, disease duration) of hemosiderosis. MATERIALS AND METHODS: 12 patients with chronic renal failure and one patient with aplastic anemia, who have received multiple transfusion, were performed MRI with a 2.0 Tesla unit. RESULTS: In All of 13 patients(17 cases), the liver revealed low signal intensity equal to background noise. In 4 of 17 cases whose serum ferritin level was below 1000 ng/ml, pancreas, gastric wall, adrenal gland were involved in 1 case. In 4 cases with serum ferritin level between 1000 and 1500, pancreas was involved in 2 cases, and other organ was involved in 1 case. In 9 cases with serum ferritin level above 1500ng/ml, pancreas involved in 9 cases, and other organ in 4 cases. CONCLUSIONS: The MR findings are well correlated with serum ferritin level whereas the TSI, LFT, disease duration are not correlated with involved organ on MR.
Adrenal Glands ; Anemia, Aplastic ; Ferritins ; Hemochromatosis ; Hemosiderosis* ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Magnetic Resonance Imaging ; Noise ; Pancreas

PURPOSE: The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity. METHODS: A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program. RESULTS: Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity. CONCLUSION: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.
Adult ; Attitude of Health Personnel ; Burnout, Professional/psychology ; Female ; Humans ; Job Satisfaction ; *Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; Personnel Turnover ; Questionnaires ; Republic of Korea

BACKGROUND: Although urticaria is a common skin reaction pattern occuring at some time in the life of approximately 15% to 20% of the population, the exact prevalence of food-induced acute or chronic urticaria remains unknown. OBJECT: The purpose of this study was to determine the prevalence of specific food allergies in patients with urticaria and the potential utility of the skin prick test and CAP-RAST FEIA in the diagnosis of food allergy. METHODS: One hundred patients with urticaria were evaluated for food hypersensitivity by history, eosinophil count, IgE, skin prick test, CAP-RAST FEIA, and open food challenge test (OFCT). RESULTS: 1) The prevalence of specific food allergies in the study population was 35% in history and 8, 18 and 6% in prick, CAP-RAST FEIA and OFCT, respectively. 2) The frequent food allergens were milk, egg, peanut, and wheat. 3) There were no correlations between the duration of urticaria and prick test, CAP-RAST FEIA and OFCT results. 4) Serum IgE levels were correlated with the prick test and CAP-RAST FEIA results, but not the OFCT results. 5) According to the history, 35 patients with urticaria answered that their symptoms were related to food, and of the 35 patients, positive reactions to the prick test and CAP-RAST FEIA were observed in 6 and 10 patients, respectively. Among the other 65 patients who answered that there was no relation between urticaria and food, 2 patients reacted positively to the prick test and 8 patients showed positive result to CAP-RAST FEIA. CONCLUSION: In contrast to high prevalence of food history, the prevalence of food-induced allergic urticaria in Korean patients is only 6%. In contrast to the prick test, CAP-RAST FEIA provides a standardized measurement of food specific IgE antibodies, which may be more useful diagnostic test than prick test to diagnose food allergy in urticaria.
Allergens ; Antibodies ; Diagnosis ; Diagnostic Tests, Routine ; Eosinophils ; Food Hypersensitivity* ; Humans ; Immunoglobulin E ; Milk ; Ovum ; Prevalence ; Skin ; Triticum ; Urticaria*

BACKGROUND: Tacrolimus (FK 506) ointment is a recently developed topical immunomodulator, and preliminary studies suggest that topical application of tacrolimus is effective in the treatment of atopic dermatitis. OBJECTIVE: Our purpose was to evaluate the efficacy and safety of 0.1% tacrolimus ointment for the treatment of moderate to severe atopic dermatitis (AD) in Korea. METHOD/Patients: A total of 57 patients, 2 to 49 years of age, with moderate to severe AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. The mean age of patients was 16.7 years. One-third of the patients had severe atopic dermatitis at baseline. Efficacy was evaluated by the Eczema Area and Severity Index (EASI) score. Other evaluations were based on the physician's and patient's global evaluation of clinical response. RESULT: Significantly more patients (p<0.001) achieved clinical improvement with 0.1% tacrolimus ointment 90.0% or better. Marked improvements in the signs and symptoms of atopic dermatitis, the EASI score and the patient's assessment of pruritus were also observed early in treatment and were maintained throughout the study. Transient skin burning and itching on the application site were the most common adverse events. Occurrence of these symptoms decreased after first few days of treatment. There was no increase in incidence of other significant adverse events. CONCLUSION: 0.1% tacrolimusimus ointment is safe and effective for the treatment of Korean AD patients.
Burns ; Dermatitis, Atopic* ; Eczema ; Humans ; Incidence ; Korea ; Pruritus ; Skin ; Tacrolimus*

BACKGROUND: With the development of bioengineering techniques for noninvasive characterization of skin pathophysiology, the induction of irritant dermatitis by surfactants has been extensively studied. OBJECTIVE: We performed this study to compare the skin responses in terms of transepidermal water loss (TEWL) and erythema induced by benzalkonium chloride (BAC), a well-known non-corrosive irritant, in comparison with sodium lauryl sulfate (SLS), a representative corrosive irritant. METHOD: We applied 0.1, 0.2, 0.5, 1, and 2% solutions of BAC and SLS on volar forearm skin for 24 hours using a large Finn chamber with filter paper disc on 19 normal healthy subjects. TEWL and erythema index (E-index) were measured prior to testing, then at 30 minutes, one day, two days, three days, one week, and two weeks after the removal of the patches. RESULTS: TEWL values of BAC and SLS patch areas increased with concentration. However, BAC induced a significantly lower TEWL increase than SLS did at the corresponding concentrations. TEWL induced by BAC was highest at 30 minutes after the removal of the patch, whereas TEWL induced by SLS was highest at one day. TEWL values had recovered with the passage of time to baseline values at 2 weeks after removal of the patch at lower concentrations (0.1, 0.2, 0.5%) of SLS, but still showed significantly high TEWL values at 1% and 2% concentration SLS patch areas. TEWL values of BAC in 0.1, 0.2, 0.5 and 1% concentrations had recovered to the baseline values at 2 weeks after the removal of the patch, but not in 2% concentration BAC patch areas. E-indices of BAC and SLS increased with concentration in a similar reaction pattern. E-index induced by BAC was highest at 30 minutes after the removal of the patch, and E-index induced by SLS was highest at 30 minutes or 1 day after the removal of the patch. E-index of each concentration, except 2%, had recovered with the passage of time to baseline values on both BAC and SLS patch areas at 2 weeks, but E-indices of both 2% BAC and SLS did not recover at 2 weeks. CONCLUSION: Benzalkonium chloride showed much less damage to the skin barrier function compared to the corresponding concentration of SLS, whilst they showed a similar degree of erythema. Skin barrier function affected by the corrosive irritant SLS would need a more prolonged recovery time than skin barrier disruption by non-corrosive irritant BAC.
Benzalkonium Compounds* ; Bioengineering ; Dermatitis, Irritant ; Erythema ; Forearm ; Skin* ; Sodium Dodecyl Sulfate* ; Sodium* ; Surface-Active Agents

PURPOSE: To evaluate the incidence, time of detection, classification, and risk factors of thyroid dysfunction in neonates at a neonatal intensive care unit. METHODS: This is a retrospective study reviewing medical records of 67 infants (including 40 very low birth weight infants, VLBW), who were admitted for more than 1 month at Chungbuk National University Hospital from July 2006 to June 2009. Initial screening and repeat thyroid function tests were performed before and after two weeks of age. RESULTS: 1) In the thyroid dysfunctional group (42/67, 62.7% including 30 VLBW), only 9 infants (including 8 VLBW) were abnormal at screening. Among 57 infants with normal screening, 33 infants (57.9%, including 22 VLBW) changed to abnormal at follow-up. The detection times at the repeat test were 2-4 weeks of age (WA) (n = 15), 4-6 WA (n = 15), and 6-8 WA (n = 3). 2) The types of dysfunction were primary hypothyroidism (PH) with marked TSH rise (n = 7), mild PH (n = 3), hyperthyrotropinemia (n = 11), hypothyroxinemia (n = 7), and non-thyroidal illness (n = 14). 3) Compared to the normal group (n = 25), the dysfunctional group (n = 42) had lower birth weight, shorter gestational age, and more morbidity of respiratory distress syndrome (P < 0.05). 4) Thyroxine was prescribed in 15cases (35.7%) in the dysfunctional group except non-thyroidal illness. CONCLUSION: Thyroid dysfunction was common in the intensively cared neonates, especially in VLBW, and many cases were detected at the repeat test. The thyroid function test should therefore be repeated at least from 2 WA to 8 WA, and a proper management plan established by investigate the characteristics and long-term prognosis of these neonates.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Incidence ; Risk Factors

Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurysmal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurysmal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered.
Adult ; Colonoscopy ; Female ; Hemangioma/*complications ; Humans ; Iron, Dietary/therapeutic use ; Klippel-Trenaunay-Weber Syndrome/complications/*diagnosis/drug therapy ; Rectum/blood supply ; Spleen/blood supply ; Tomography, X-Ray Computed ; *Varicose Veins