1. Instruction. Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project on order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was meeded. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myum. 2. Survey Method. An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing technique for three days. The team consisted of a public health nurse, four nurse-aides, a asnitarian and four health extension workers who are working in our project. The survey was carried out during the period November 1971 to March 1972. 3. Project area. 1) Population of Soyang-Myum was 11,668 ; male, 5,962 and female, 5,706. Sex ratio : 104.5. 2) Households : 1,858. 3) Family size : The average household consisted of 6.3 persons. 4) Education level of householder. a. Illiterate 13%. b. No schooling but able to read 10%. c. Preschool Children 19%. d. Primary School 47%. e. Middle School 7%. f. High School 3%. g. College or University 1%. 5) Occupational distribution of householders. a. Farmer 67%. b. Laborer 13%. c. Office worker 4%. d. Merchant 4%. e. Industrial worker 2%, f. Unemployed 8%, g. Miscellaneous 2%, 6) Religious affiliation. a. No religion 74%, b. Buddhist 12%, c. Protestant 10%, d. Catholic 4%. 4. Survey results. Living Environment : a. Home ownership 95%, b. Kinds of roofing. Straw-thatched house 84%, Tile-roofed house 10%, Slate-roofed house 5%, Other 1%. c. Floor space, Less than 6 pyong 10%, 6-10 pyong 53%, 1-15 pyong 24%, 16-20 pyong 9%, More than 20 pyong 4%, d. Radio ownership 80%. Environment : a. the source of drinking water. public well 49%, private well 30%, drainage water 9%, steam water 8%, well pump 3%, water distribution system 1%, b. Distance between well and toilet. more than 16 meter 38%, 6-10 meter 31%, 11-15 meter 14%, Less than 6 meter 17%. c. The status of well management. Bad 72%, Fair 26%, Good 12%. d. General sanitary of well management. Bad 37%, Fair 51%, Good 12%. e. House drainage system. had no house drainage 77%. Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods. loop 68%, oral pill 16%, vasectomy 4%, condom 1%, tubal ligation 1%, two or more methods 10%. Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26%, 6 times 11%, 5 times 11%, 4 times 9%. b. The place of delivery. own house 88%, hospital 1%, others 11%, Treatment of general sickness. a. The place of treatment, Soyang Health Center 31%, Hospital(Private or otherwise) 26%, Pharmacy 14%, Herb medicine 5%, Private care 5%, No treatment 12%, Miscellancous 7%. b. Usual causes of disease. Unknown 46%, Tuberculosis 29%, Neuralgia 8%, CVA 3%, Bronchitis 3%, Others 11%.
Bronchitis ; Child, Preschool ; Community Health Services ; Community Medicine ; Condoms ; Contraceptive Agents ; Surveys and Questionnaires ; Drainage ; Drinking Water ; Education ; Family Characteristics ; Family Planning Services ; Female ; Fertilization ; Health Surveys* ; Humans ; Male ; Maternal Health ; Neuralgia ; Nurses, Public Health ; Ownership ; Pharmacy ; Protestantism ; Sanitation ; Sex Ratio ; Steam ; Sterilization, Tubal ; Tuberculosis ; Vasectomy ; Vital Statistics ; Water

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.
Age of Onset ; Antibodies ; Arthritis ; Autoantibodies ; Biological Phenomena ; Connective Tissue ; Female ; Fetus ; Humans ; Immune System ; Lupus Erythematosus, Systemic* ; Male ; Menopause ; Mothers ; Pregnancy* ; Prevalence

No abstract available.
Laser Coagulation* ; Prostatic Hyperplasia*

Waardenburg syndrome is a very rare auditory-pigment syndrome with autosomal dominant inheritance. In his first report in 1951, Waardenburg characterized this syndrome as dystopia canthorum, a high broad nasal bridge, synophrys[confluent eyebrows], heterochromia iridid, a white forelock or early graying, and sensory neural deafness. We observed a case of Type 2 Waardenburg syndrome with openangle glaucoma and, therefore report with literature review.
Deafness ; Glaucoma ; Glaucoma, Open-Angle* ; Waardenburg Syndrome* ; Wills

No abstract available.

The air-borne fungi are usually considered to be as non-pathogenic and saprophytic organisms. However, those can be causative factors of certain allergic disease, and produce mycotoxic diseases such as caused by aflatoxin B1,or opportunistic infections, since various kinds of antitumor agents and adrenocorticosteroids have been introduced to therapeutics, and those who are affected some malignant tumors or metabolic anomalous diseases. As the first step toward. understanding and controlling the diseases, the studies on the population of air-borne fungi seem to be necessary. Authors studied the fluctuations of population of air-borne fungi at monthly intervals from June 1974 through May 1975 and at various times of the day at different places in th hospital, and the results obtained were as follows: 1. The identified fungi species and the percentage of colony counts of each species were Hormodendrum sp. (37. 2% ), Penicillium sp. (18. 8% ), Aspergillus sp, (17. 6 % ), Alternaria sp. (6.3 %), Mycelia sterila (2.6 %), Paecilomyces sp. (1.2 %) RhodO torula sp. (1. 1 % ), Oospora, sp. (0, 7 % ), Rhizopus sp. (0. 6 %. ), Geotrichum sp. (0.4%), Monilia sp. (0.4%), Mucor sp. (0.4%), Trichoderma sp. (0.4%.), Trichosporon sp. (0. 1%), Stemphylium sp. (0. 1 % ), Helminthosporium sp. (0. 1%) Gliocladium sp. (0. 1,: ), Saccharomyces sp. (0. 1 % ), Trichothecium sp. (0. 03 % ), and other unknown species(11. 6%) in decreasing order of frequency. 2. The monthly fluctuations of number of cultured colonies of four major airborne fungi (Hormodendrum, Penicillium. Aspergillus, and Alternaria) were 649 in June, 105 in July, 372 in August, 431 in September, 188 in October, 241 in November and 89 in December 1974, and 92 in January, 115 in February, 77 in March, 178 in April and 116 in May 1975. 3. It was suggested that there might be a relationship among the humidity, the temperature and the population of the air-borne fungi because the abrupt drop in July seemed to be related to high level of tbe,humidity (86.8%) and the temyerature (24. 3'C). And since the total number of colonies decreased markedly in December 1974 and Junuary 1975, it seemed to be closely related to cold weather temperature. 4. The number of cultured colonies at various times of the day did not show much fluctuation, except that Aspergillus sp. showed sudden tremendous increase at. one occasion, at 3: 00 P.M. on 15th of June and that gradual increase of Hormodendrum sp. was noted on another occasion from 12: 00 A.M. on 15th of September. 5. With regard to the locations of sampling, such as the operating room, laboratory, ward and out-patient department in the hospital, the difference in the identified. fungi species, the number of colony counts and the relationship with the humidity A the temperature was not evident. Authors reviewed relevant literatures and made discussions also.
Aflatoxins ; Alternaria ; Antineoplastic Agents ; Aspergillus ; Candida ; Cryptococcus ; Fungi* ; Geotrichum ; Gliocladium ; Helminthosporium ; Humans ; Humidity ; Mucor ; Operating Rooms ; Opportunistic Infections ; Outpatients ; Paecilomyces ; Penicillium ; Rhizopus ; Saccharomyces ; Trichoderma ; Trichosporon ; Weather

Endobronchial tuberculosis is granulomatous inflammation of the bronchial mucosa characterized by bronchial ulceration due to caseous necrosis. There is a good chance to expectorate cellular components of granulomas in the sputum. The author studied a cytologic series from 46 patients with endo-bronchial tuberculosis confirmed on fiberoptic bronchoscopic biopsy. The cytologic series consisted of 32 sputa, 41 washings, and 17 bronchial brushings, and were carefully screened for elongated epithelioid cells, Langhan's type giant cells, other multinucleated giant cells and caseous material. Elongated epithelioid cells were demonstrated in 9 sputa (28.1%), 30 bronchial washings (73.2%) and 11 brushing smears (64.7%). Langhans' giant cells were observed in two of 32 sputa (6.2%), six of 41 bronchial washings (14.6%) and four of 17 bronchial brushings (23.5%). The caseous materials were noted in 19 of 32 sputa (59.4%), 32 of 41 bronchial washings (78.0%), and 14 of 17 bronchial burshings (82.4%). It appeared that the pertinent cellular components of granulomas in sputa or bronchial secretions indicated a strong evidence of endobronchial tuberculosis of the lung.

Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

No abstract available.
Antibodies, Monoclonal* ; Chlamydia trachomatis* ; Chlamydia*