Apert described acrocephalosyndactyly as a clinical entity in 1906. At first he included a patient with craniofacial deformities combined with syndactyly of both the upper and lower extremities. This is a rare congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. More than 200 cases have been reported in the world literature, and three cases in Korea. Authors experienced one case of the classic pattern of Apert's syndrome and treated surgically for syndsctyly.
Acrocephalosyndactylia ; Congenital Abnormalities ; Foot ; Hand ; Head ; Humans ; Korea ; Lower Extremity ; Syndactyly

OBJECTIVES: The aims of this study were to discriminate the clinical differences, to measure the estrogen and homovanillic acid levels. to evaluate a correlation between estrogen and homovanillic acid. and to identify an association of cognitive deficit with estrogen and homovanilli acid among male and female schizophrenics. METHODS: In addition to the structured interviews, the plasma estrogen levels by radioimmunoassay and the homovanillic acid levels by HPLC were measured in 20 male and 21 female schizophrenics as well as 10 healthy male and 9 female controls. RESULTS: 1) The plasma estrogen levels were higher in females than males, and significantly higher in female schizophenics than female controls. The homovanillic acid levels were higher in female schizophrenics than female controls, and were lower in male schizophrenics than male controls. 2) The onset age seemed to be earlier in male schizophrenics, and the frequency of admission, duration of antipsychotic drug administration. dosage of antipsychotics and duration of illnesses were more in males. The estrogen and homovanillic acid levels were significantly higher in female schizophrenics. 3) The estrogen levels had a significant positive correlation with sex, age and onset age, while the homovanillic acid levels did with sex. However, estrogen wee not correlated with homovanillic acid levels. 4) The estrogen and homovanillic acid levels were not significantly different between male and female schizophrenics with cognitive deficits. In the schizophrenic patients without cognitive deficits, the estrogen levels were significantly higher in females, while here were no significant sex differences in homovanillic acid. 5) In the male and female schizophrenics predominantly with negative symptoms, there were no significant differences in estrogen and homocanillic acid levels. In those predominantly with positive symptoms, the estrogen levels wee significantly higher in females, while there were no sex differences in homovanillic acid levels. 6) In schizophrenics with undifferentiated subtype, the estrogen and homovanillic acid levels were significantly higher in females. In those with paranoid or disorganized subtypes. the estrogen levels were significantly higher females, while there were no sex differences in the homovanillic acid levels. 7) The mean values of PANSS-negative. PANSS-total, PANSS-CF, MMSE-K and estrogen levels were significantly higher in male schizophrenics with cognitive deficits. The mean values of illness duration, CGI PANSS-positive, PANSS-negative, PANSS-total, PANSS-CF and MMSE-K were significantly higher in female schizophrenics with cognitive deficits. 8) The variables which showed significant correlation with cognitive deficits were PANSS-nagative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels in male schizophrenics. The variables which showed significant correlation with cognitive deficits were subtypes, onset age, illness duration, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANMSS-CF and MMSE-K in female schizophrenics. The estrogen levels were significantly correlated with admission frequencies, history of antipsychotic administration, duration of antipsychotic administration and cognitive deficits in male schizophrenics. while age were not correlated with in females. The homovanillic acid levels had a significant correlation with subtypes and onset age in male schizophrenics, while there were no correlation among variables in females. CONCLUSIONS: Although the plasma concentrations of estrogen and homovaillic acid in female schizophrenics were significantly higher than males, we could not find an association between them. Furthermore, the various factors affecting on the cognitive deficits, estrogen and homovanillic acid levels seemed to be somewhat different according to sex.
Age of Onset ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Estrogens* ; Female ; Homovanillic Acid ; Humans ; Male ; Plasma ; Radioimmunoassay ; Schizophrenia* ; Sex Characteristics

BACKGROUND: After the World-Wide-Web(www) appeared, history has abruptly fallen in the new era of the Internet. In Korea, after the first medical internet site appeared, there was a major development in the WWW. But the quality and quantity of the web-page remains in infancy. Therefore, through the analysis of the Korean medical internet sites on present status, directions for development of Korean medical internet sites can be made. METHODS: From April 1st, 1999 to June 30th, 1999 in the Korean web sites, we visited 1044 sites. They included "Medmark Korea" representing medical search engine, "Eulji medical library" in the Eulji Medical College Hospital, and the medical sites of the "Yahoo Korea", "naver.com", and "simmani.com". Through this internet search, the information about locations, first publication year, classification by characteristics of homepage, speciality, web service form was obtained. Among these sites, acquireing from insufficient source further, questions were sent to the webmasters of 143 websites by e-mail. The questions included 7 items on the characteristic of webmasters, 8 items on the general characteristics of internet sites, 8 items on the contents, and their own comments. RESULTS: The occupation of webmasters was as follows: were physicians 94.4%, were male. According to age distribution, those in their thirties was 48.2%, and forties, 33.3%. Amone the 521 websites confirmed, there were 44 sites in 199 151 in 1996, 237 in 1997, and 79 in 1999. According to the distribution of location, metropolitan areas including Seoul, Inchon, Kyonggi occupied 68.9% among total. The main portion of the intentional visitors was ordinary people comprising 39.2%, members 9.8%, and physicians 7.7%. Concerning the purposes of publication, 38.7% of websites intended for health education to citizens, 31.0% for publicity of hospital or organizations, and 15.5% for exchange of information between members. For the most significant contents, 26.6% focused on the common-sense health issues, 35.7% on exchange of special medical information, 8.4% on education data for medical students, and 13.3% on publicity of hospitals. For the update interval, 22.0% renewed their sites within 1 week, 22.7% in 1 month, 23.4% in 3 months, and 20.6% in 6 months. For the effectiveness of homepage, the rate of `good' and `very good' response was 52.8%. CONCLUSION: Our investigation, showed that medical internet sites are lead by those in their thirties and forties. Web sites was concentrated to metropolitan areas where informational infrastructure was well developed. It is emphasized that efforts to informationalization by are needed by, governmental medical database systems should be established, and that the guidelines which enables validity of medical information should be set forth.
Age Distribution ; Classification ; Education ; Electronic Mail ; Gyeonggi-do ; Health Education ; Humans ; Incheon ; Internet* ; Korea* ; Male ; Occupations ; Publications ; Search Engine ; Seoul ; Students, Medical

PURPOSE: We studied clinical patterns of the febrile infants and children presenting to the Pediatric Emergency Department(ED) in the general pediatric population. METHOD: We analyzed 1,764 infants and children who had a history of measured body temperature of 38.3degrees C or higher, before or after arrival at Pediatric ED of Ilsan Paik Hospital from September 2004 to August 2005. We analyzed their clinical patterns, such as the frequency of febrile illness, age distribution, monthly distribution, diagnosis. RESULT: The frequency of the febrile illness at Pediatirc ED was 19.9 percent (1,764/8,881 cases). The percentage of admission into hospital was 26.4 percent. The most common age group presenting to Pediatric ED with febrile illness was the 12-23 months group(22.8 percent) followed by the 4-11 months group and the 2 years group. In May, the most numerous patients presented to the Pediatric ED with febrile illness. The frequency of febrile illness was significant higher in the 'Spring & Summer group' compared to the 'Autumn & Winter group'. The ratio of male to femal was 1.4:1. The most common diagnosis was acute pharyngitis(42.5 percent), followed by acute gastroenteritis (15.3 percent), pneumonia(7.0 percent). CONCLUSION: The frequency of the febrile illness at Pediatirc ED was 19.9 percent. The most numerous patients visited Pediatric ED in May. And, the most common age group was 12-23 months. The proportion of non-urgent disease, such as acute pharyngitis, acute gastroenteritis, acute nasopharyngitis and acute bronchitis, was high. There is a need to educate parents and improve the medical system in Korea.
Age Distribution ; Body Temperature ; Bronchitis ; Child* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Fever ; Gastroenteritis ; Humans ; Infant* ; Korea ; Male ; Nasopharyngitis ; Parents ; Pharyngitis

No abstract available.
Sturge-Weber Syndrome*

BACKGROUND: Evaluating the segmental wall motion of left ventricle is important in patients with myocardial infarction for choosing therapeutic modality and predicting prognosis. Radionuclide Multigated Angiography(MUGA) is a reliable noninvasive method for the evaluation of left ventricular performance. Methods : MUGA scan(LV ejection fraction, phase image histogram, regional wall motion) was performed and analyzed in 45 patients with myocardial infarction(31 : acute MI, 14: old MI) and 13 normal controls. RESULTS: 1) The LVEF of acute and old MI group was significantly reduced and the SDph of acute and old MI group was significantly increased as compared with that of control group(p<0.05). 2) In acute MI group, the LVEF of group without, IV Urokinase was more reduced than that of group with IV Urokinase and the SDph of group without IV Urokinase was more increased than that of group with IV Urokinase(p<0.05). As a result of wall motion scoring, the linear correlation exists between SDPh and sum of wall motion scoring(r=0.62, p<0.01). 3) In MI group, the LVEF of anterior wall MI was more reduced than that of inferior wall MI and the SDPh of anterior wall MI was more increased than that of inferior wall MI(p<0.05). 4) In acute anterior wall MI, the reverse correlation exists between LVEF and SDPh and the linear correlation exists between sum of wall motion scoring and SDPh(r=-0.73, 0.72, p<0.01). But there are no statistical significances of correlation between them in acute inferior MI(r=-0.44, 0.42, p>0.05), in old anterior MI(r=-0.65, 0.47, p>0.05) and in old inferior MI(r=-0.47, 0.46, P>0.05). CONCLUSION: These results suggest that Phase angle(SDPh) is thought to be valuable index to evaluate left ventricular function with application of other indeces in Myocardial infarction. Left ventricular function measured by SDph in acute or anterior MI is lower than old or inferior MI.
Heart Ventricles ; Humans ; Myocardial Infarction* ; Prognosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left

BACKGROUND: Paederus derriattis is a peculiar linear lesion caused by an insect belonging to genus Paederus, family Staptylinidae, order Coleoptera. The deliberate or accidental contact of crushed coelomic fluid of th insect, on the skin causes acute lesions due to a t.oxin(pederin) being released. OBJECTIVE: The study was nade in order to investigate an epidemic status of the peculiar der matitis and its causative agent of factor prevailing in the midwest area of Kyungpuk province. METHODS: We performed field approaches on 633 cases(M: 303, F: 330) including cases enrolled in a local clinic, teamiring up with a local skin clinician over the 3-month period of August November in 1994. RESULTS: 1. The captive insect causing the present dermatits, was identified as Paederus fuscipes(PF). The epidemic might be attributeid to the climatic conditions with higher temperature than usual during the period of July-eary September in the past year by 3-4degrees C as well as a lower relative humidity. The active temperature zone for PF was presumed to be about 15.5+1.2degrees C to 28.9+1.0degrees C 2. There was the highest p;evalence of 412 cases(65.1%) in early September, followed by mid September, late August, early October and mid August in a small number of cases in decreasing order. The cases were not found after mid October. 3. All age groups were evealy represented. The sex ratio was 1: 1.1 with little difference. The majority of cases lived in Kiriich on city(80.3%), with a lesser outbreak in the neighboring coun ties and Kumi city. 4. The preferred site was the mainly exposed area such as face, neck and extremities. The number of lesion was single(60%) and multiple(40%). The lesion showed a common linear con figuration and acute irritant contact dermatitis consistent with the histologic finding. CONCLUSION: The unusual wiather conditions and poor environmental hygiene help to develop an ecosystem breakdown, which, in turn, sometimes influences the innocuous insects life to be harm ful being on humans, as like outbreak of PF dermatitis.
Beetles ; Dermatitis* ; Dermatitis, Contact ; Ecosystem ; Epidemiologic Studies* ; Extremities ; Gyeongsangbuk-do ; Humans ; Humidity ; Hygiene ; Insects ; Neck ; Sex Ratio ; Skin

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

PURPOSE: The purposes of this study were to develope and evaluate a constipation intervention program for inpatients. METHOD: To develope this program, Six phases were processed including the organization of team, the analysis of medical chart, the development of tentative constipation intervention program, the test of content validity, the test of clinical validity and the determination of final constipation intervention program. To evaluate the clinical validity of this program, 10 subjects who were in the C University Hospital were selected from March, 2001 to October, 2001. RESULT: The clinical validity was supplied by the pilot test, showing the potential effect of the program. Based on the validity results the final algorithm and the form of nursing record for this program which consist of the 3-step assessments and the intervention protocol were presented in this study. CONCLUSION: The advantage of this program is being able to assess and manage constipation simultaneously and is especially effective to patients who are at risk for developing constipation during their admission. Further study needs are also necessary to evaluate the effect of this program on the self-symptom of constipation.
Constipation* ; Humans ; Inpatients* ; Nursing Records ; Program Development

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.
Culture Media ; Gangwon-do ; Mycobacterium ; Ovum