BACKGROUND: Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drags involving OFX. METHOD: A retrospective study was made through the regular follow up of smear positive cases,who treated by four drag, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(PAS). RESULTS: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advavanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78% , 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the duration of patients illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52%. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). CONCLUSION: The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.
Abdominal Pain ; Aminosalicylic Acid* ; Communicable Diseases ; Cycloserine* ; Follow-Up Studies ; Humans ; Liver ; Nausea ; Prothionamide ; Pruritus ; Retreatment* ; Retrospective Studies ; Skin ; Sputum ; Tuberculosis, Pulmonary* ; Vomiting

BACKGROUND: Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drags involving OFX. METHOD: A retrospective study was made through the regular follow up of smear positive cases,who treated by four drag, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(PAS). RESULTS: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advavanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78% , 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the duration of patients illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52%. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). CONCLUSION: The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.
Abdominal Pain ; Aminosalicylic Acid* ; Communicable Diseases ; Cycloserine* ; Follow-Up Studies ; Humans ; Liver ; Nausea ; Prothionamide ; Pruritus ; Retreatment* ; Retrospective Studies ; Skin ; Sputum ; Tuberculosis, Pulmonary* ; Vomiting

Segmental fractures of the clavicle are very rare. Therefore, to date, there has not been a clear, standardized method of management of segmental clavicle fractures. Herein, two patients with a segmental fracture are described: One patient was treated conservatively, while another patient was treated operatively. Both patients showed excellent results. We discuss the various management options with a literature review.
Clavicle* ; Humans ; Methods*

To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examlnees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, 75.2+/-34.3 microgram/l(mean+/-standard deviation), p<0.01) and gastroduodenal ulcers (n=8,756+/-19.8 microgram/l, p<0.05), and was lower in those with gastric adenoma (n=4,37.7+/-37.2 microgram/l, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, 56.6+/-24.9 microgram/l). Serum PG II level las higher in subjects with active duodenal ulcer (17.2+/-13.8 microgram/l, p<0.2), active gastro-duodenal ulcers (l8.3+/-7.4 microgram/l, p<0.2) and gastric carcinoma (n=3, 23.8+/-10.9 microgram/l, p<0.05) than those with normal, mild gastritis findings or ulcer scars (14.5+/-7.9 microgram/l). Serum PG I/PG 11 ratio was higher in subjects with active duodenal ulcer (5.1+/-1.6, p<0.05) and was lower in those with chronic gastritis (n=107, 4.1+/-1.7, p<0.05), gastric polyp (n=19, 3.9+/-1.4, p<0.2), gastric adenoma (n=4, 2.1+/-1.9, p<0.01) and gastric carcinoma (n=3, 2.7+/-1.2, p<0.1) than those with normal, mild gastritis findings or ulcer scars (4.5+/-1.7). Serum PG 11 level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<70 microgram/l and PG I/PG II ratio<3.0 for detecting gastric cancer and adenorna gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.
Adenoma* ; Cicatrix ; Duodenal Ulcer ; Gastritis ; Immunoradiometric Assay ; Korea* ; Mass Screening* ; Pepsinogen A* ; Peptic Ulcer ; Polyps ; Sensitivity and Specificity ; Stomach Neoplasms* ; Ulcer

To study the pattern of prenatal care utilization and its determinants in rural Korea, 976 mothers(65.5%) out of 1,489 living mothers in Chinyang, Sachon and Hapchon Counties in Kyongsangnam Province who had delivered a baby between July 1, 1990 and June 30, 1991 were interviewed by the Myon health workers from January 3 through February 15, 1992. The Andersen's behavioral model for health service utilization was applied to develop the frames for analysis. The dependent variable was a number of prenatal care visits. And the independent variables included in the model were the variables pertaining to the predisposing, enabling, medical need and other components. The proportion of mother who had ever received the prenatal care service for the index pregnancy was 97.3%. However, the proportion of mothers who had made more than 10 visits was only 20.6%, which indicated that majority of mothers had paid far less visits than recommended 10~12 visits for each normal pregnancy. The low utilization of prenatal care services(none or less than 4 visits) was related to mother's low educational level, the high birth order, beneficiary of the medical aid, the absence of clinic in the community, no diagnosed disease of mother during pregnancy, and mothers engaged in farming. Inequity of access seemed to exist because social structure variables and the variables of enabling component were important predictors. And there seemed to be high mutability in equalizing the distribution of prenatal care services because the variables of enabling component such as type of medical security and whether there was a clinic or not in the community were substantially important.
Birth Order ; Gyeongsangnam-do ; Health Services ; Humans ; Korea* ; Mothers ; Pregnancy ; Prenatal Care*

The laser is a new surgical modality that utilizes high intensity beams of radiant energy to vaporize or coagulate tissue. Radiant energy is generated by stimulated emission of photons, resulting in a unidirectional monochromatic beam that is temporary coherent small diameter beams of great power density are achievable by this means. The author reviewed 12 months experience with a CO2 laser involving neurosurgical operations. 29 neurosurgical lesion, i, e. brain tumor 17 intracerebral hemorrhage 10, cerebral paragonimiasis 1, and arteriovenous malformation 1, were removed with the use of Shaplan, CO2 laser since 1981. We have conclude that there had been a significant reduction in blood loss and neurological morbidity through it was readily conceded that the number of operations were relatively small. The particular advantages of the combination of CO2 laser and microscope were felt to be precision, reduction of mechanical trauma, good hemostasis and low cost. Especially the blood loss and replacement during operation have been reduced.
Arteriovenous Malformations ; Brain Neoplasms ; Cerebral Hemorrhage ; Hemostasis ; Laser Therapy* ; Lasers, Gas ; Paragonimiasis ; Photons

The laser is a new surgical modality that utilizes high intensity beams of radiant energy to vaporize or coagulate tissue. Radiant energy is generated by stimulated emission of photons, resulting in a unidirectional monochromatic beam that is temporary coherent small diameter beams of great power density are achievable by this means. The author reviewed 12 months experience with a CO2 laser involving neurosurgical operations. 29 neurosurgical lesion, i, e. brain tumor 17 intracerebral hemorrhage 10, cerebral paragonimiasis 1, and arteriovenous malformation 1, were removed with the use of Shaplan, CO2 laser since 1981. We have conclude that there had been a significant reduction in blood loss and neurological morbidity through it was readily conceded that the number of operations were relatively small. The particular advantages of the combination of CO2 laser and microscope were felt to be precision, reduction of mechanical trauma, good hemostasis and low cost. Especially the blood loss and replacement during operation have been reduced.
Arteriovenous Malformations ; Brain Neoplasms ; Cerebral Hemorrhage ; Hemostasis ; Laser Therapy* ; Lasers, Gas ; Paragonimiasis ; Photons

Congenital cystic adenomatoid malformation of the lung (CCAM) is a rare benign pulmonary lesion characterized by abnormal overgrowth of the fetal bronchiole. The prenatal diagnosis of CCAM is important because the prognosis of the CCAM is depend on the type, bilaterality, and other associated abnormalities, which can be detected by prenatal ultrasonography. We experienced a case of CCAM that was detected by prenatal ultrasonography and report the case with a review of several related literatures.
Bronchioles ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Lung* ; Prenatal Diagnosis ; Prognosis ; Ultrasonography, Prenatal

Lateral eyebrow mass with primary skull lesion are rare in pediatric population. Although epidermoid cyst and dermoid cyst are the most commonly encountered skull lesions in pediatric population, Langerhans cell histiocytosis (LCH) is rarely reported. We report a case of LCH arising from the lateral eyebrow with osteolytic lesion involving the frontal bone. A 5-year-old boy was presented with a hard, fixed mass in his lateral eyebrow. Contrast magnetic resonance imaging revealed inhomogeneous enhancement of the mass with direct invasion of the frontal bone and adjacent dura mater. Under general anesthesia, linear incision at the lateral eyebrow region was made. Intraoperative evaluation revealed hard, fixed and well-defined soft tissue mass. The final extirpated mass was 2.5 x 2.4 cm in size, and was accompanied by a 1 x 1 cm sized defect on the frontal bone with intact dura mater. The surgical wound was closed primarily by a layer-by-layer fashion. Histologic examination was later performed for definite diagnosis. The histologic examination revealed abnormal proliferation of Langerhans cell with granuloma formation. Radionuclide bone scan and positron emission tomography was taken and revealed free of multi-organ involvement. At 3 months after surgery, natural looking contour at the lateral eyebrow region was observed with no tumor recurrence. Differential diagnosis of the hard and fixed mass at the lateral eyebrow region affecting the primary skull lesion from pediatric population includes epidermoid cyst, dermoid cyst and LCH. Generally, brief physical examination with plain X-ray view can be performed for clinical evaluation, but for a definite diagnosis, contrast MRI may be helpful.
Anesthesia, General ; Child ; Dermoid Cyst ; Diagnosis, Differential ; Dura Mater ; Epidermal Cyst ; Eyebrows ; Frontal Bone ; Granuloma ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Positron-Emission Tomography ; Recurrence ; Skull

The extension type locked metacarpophalangeal joint of the little finger is an extremely rare condition characterized by loss of flexion with little or no loss of extension. The most common cause for locking is entrapment of a strap of the ruptured palmar plate. We treated a locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of locking was a torn part of the palmar ligament that forcefully rides across the prominence of the radial condyle of the metacarpal bone together with the accessory collateral ligament. These dislocated parts of the ligament formed a constricting bundle that prevented closed reduction. Locking was released successfully by an open reduction using the dorsal approach of the metacarpophalangeal joint without complication.
Collateral Ligaments ; Fingers* ; Ligaments ; Metacarpophalangeal Joint* ; Palmar Plate