In order to understand the epidemiologic characteristics and trends of Leptespirosis in Korea, year book of acute infectious disease and literatures published were thoroughly reviewed. The results obtained are as follows: 1. The outbreak of Leptospirosis in Korea has decreased during recent years. Most of the patients occured in Semptember, October, and November. Seventy nine percent of reported patients occured in north Choongchung, south Choongchung, and Kyunggi province in 1987-1991. 2. Leptospires isolation rates were ranged from 0.2% to 16.0% among normal healthy person, higher in rural residents than military personnels. 3. Total of 92 strains were isolated from human in six years from 1984 to 1990. Its main serogroups were Icterhaemorrhagiae and Canicola, predominantly consisted of serovar lai, copenhageni and canicola. Eighteen strains of Biflexa were also isolated from healthy persons and patients. 4. The proportion of Leptospirosis among patients with acute febrile episode has decreased since 1985. Sero-positive rate of male among patients with acute febrile episode is higher than that of female. Sixty percent of sero-positive patients with acute febrile episode was older than 40-year of age. The seropositive rates were consistently the highest in harvest season than other seasons. Residents of north Choongchung, north Chunlla, south Chunlla, Kyunggi, and north Choongchung provinces showed higher seropositive rates than those of other ones. Main serogroups positive to most sera of Koreans were Icterohaemorrhagiae and Canicola. 5. The sero-positive rate of normal healthy persons ranged from 2.0 to 25. 6% ; the sero-positive rate of rural area was 4 to 8 times higher than that of healthy urban people. Little difference was observed in sero-positive rate by age group among above 40 years old people, although it was higher in male by sex, in farmers by occupation and in some provinces by area.
Adult ; Communicable Diseases ; Female ; Gyeonggi-do ; Humans ; Korea* ; Leptospirosis* ; Male ; Military Personnel ; Occupations ; Seasons

The range of acetabular cup and femoral prosthesis according to the different angle of insertion has been reported by many investigators. But no reports are still avairable about the surface area of the exposed femoral head at the position causing unstability of the femoral head. So the authors had studied the 3 types of prosthesis of Charnley, Muller and Mckee-Farrar and their acetabular cup by inserting them at different angles into the 10 human cadavaric skeleton to obtain the most stable position of the prosthesis and to calculate the surface area of the femoral head at the stable position. The result obtained are as follows. 1. In. Flexion: Among 3 types of prosthesis, the maximum stability is 78% to the exposed area of the femoral head in Mckee-Farrar prosthesis with 10 of the femoral anteversion, 45 of acetabular inclination and 45 of acetabular anteversion. The minimum stability is 41% to the exposed area of the femoral head in Mckee-Farrar prothesis with femoral neutral version, 45 of acetabular inclination and 15 of acetabular retroversion. 2. In Abduction: Among 3 types of prosthesis, the maximum stability is 86.5% to the exposed area of the femoral head in Mckee-Farrar prosthesis with 10 of the femoral anteversion, 45 of acetabular inclination and 45 of acetabular anteversion. The minimum stability is 50% to the exposed area of the femoral head in Muller prosthesis with femoral neutral version, 45 of acetabular inclination and 30 of acetabular retroversion. 3. In External Rotation: Among 3 types of prosthesis, the maximum stability is 85. 8% to the exposed area of the femoral head in Mckee-Farrar prostbesis with femoral neutral version, 45 of acetabular inclination and 30 of acetabular retroversion. The minimum stability is 46% to the exposed area of the femoral head in Mckee-Farrar prosthesis with femoral neutral version, 30 of acetabular inclination and acetabular neutral version. 4. There was no relationship between the degree of range of the femoral prosthesis & acetabular cup and the amount of the surface area of the exposed femoral head when dislocated.
Acetabulum ; Head ; Hip Joint ; Hip ; Humans ; Prostheses and Implants ; Research Personnel ; Skeleton

No abstract available.
Spinal Cord Diseases*

BACKGROUND: Combined spinal epidural anesthesia (CSE) often produces a more extensive spinal block than expected. This study was designed to evaluate the effects of CSE on subarachnoid block in patients undergoing lower extremity surgery. METHODS: Thirty-three patients who undergone lower extremity surgeries were randomly allocated to three groups of 11 patients each. Using needle through needle technique, all patients received a subarachnoid injection of hyperbaric 0.5% bupivacaine 1.6~2.0 ml through a 25G Whitacre spinal needle. Group 1 received no extradural injection for 25min, but group 2 and 3 received extradural saline 10 ml and bupivacaine 10 ml 5min after the subarachnoid injection, respectively. Levels of sensory and motor block were assessed at 4, 6, 8, 10, 15, 20, and 25 min after subarachnoid injection. RESULTS: The median values of maximum sensory block level were T7 in all groups. Levels of sensory blockade and the time to onset of maximum sensory blockade were similar among the three groups. There was no significant difference in the degree of motor block among three groups. CONCLUSIONS: This study suggests that extradural saline 10 ml or 0.5% bupivacaine 10 ml which injected 5min after subarachnoid injection does not significantly influence the level of subarachnoid block in lower extremity surgical patients. However, further study is required to declare the safety or optimal dose of extradural injection during CSE.
Anesthesia, Epidural* ; Bupivacaine ; Humans ; Injections, Epidural ; Lower Extremity* ; Needles

No abstract available.
Multicystic Dysplastic Kidney* ; Ultrasonography*

Serologic tests for syphilis including VDRL and TPHA tests were carried out in 5,413 VISA applicants for emigration, from January, 1981 to December, l984 The results are summarized as follows: 1. In 5,413 VISA applicants, the reactive rate of VDRL test was 2,0% totally. The reactive rate of VDRL test of male was 2. 6%, and that of female was 1. 6% 2. The reactive rate of 1983 was 1.4% and that was the lowest in annual incidence, but there was no statistically significant differences in comparing the annual incidences. 3. The reactive rate increased with age, and males above the 5 th decade revealed an especially high reactive rate. 4. The biologic false positive rate of VDRL teet was 16. 5%, in gl VDRL reactive persons, using TPHA as standard. 5. The quantitative test of VDRL showed low titer below 1: 4 in 88. 4%, and high titer above 1: 8 in 11. 6% of the applicants.
Emigration and Immigration ; Female ; Humans ; Incidence ; Male ; Serologic Tests* ; Syphilis*

BACKGROUND: Experience of awareness and recall during general anesthesia would be most distressing for patients. Especially for the cesarean section, medical team must consider both maternal awareness and fetal safety. Authors tried to know the possibility of propofol use as induction and maintenance agent of anesthesia for the cesarean section in respect of maternal awareness, recall and fetal safety. METHODS: Forty patients (ASA physical status 1, 2) were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. We checked B.P, pulse rate, and the incidence of maternal awareness using the isolated forearm technique (IFT). The postoperative interview was conducted between 12~24h after operation. RESULTS: The incidence of maternal awareness signaled by flexing fingers in response to voice commands were significantly lower in the T-E group (20% after induction, no response during other times) than the P group (45% after induction, then 35%, 30%, after 5, 10 min delivery respectively). Seven patients had postoperative recall of introspective awareness in the P group but no patients in the T-E group. The 1 min Apgar score of the newborn were significantly lower in the P group than the T-E group but both groups were within normal range. CONCLUSIONS: Our date indicated that, in comparison with thiopental-enflurane, propofol infusion (6 mg/kg/h) were associated with a greater incidence of awareness during surgery and recall.
Anesthesia* ; Anesthesia, General ; Apgar Score ; Cesarean Section* ; Female ; Fingers ; Forearm ; Heart Rate ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Propofol ; Reference Values ; Voice

No abstract available.
Phenytoin* ; Stevens-Johnson Syndrome*

Eccrine angiomatous hamartoma is a distinct developmental anomaly showing, histologically, hyperplasia of eccrine sweat apparatus and of vascular elementa in the same lesion, and clinically, the angiomatous lesions with occasional tenderness and profuse local sweating. Recently, we examined an 18-year-old, otherwise healthy girl having, on the anterior aspect of the right leg, an extensive, irregularly marginated and somewhat bluish, tender, firm subcutaneous mass. The mass was studded with several overlying macular, verrucous or nodular angiomatous patches which showed conspicuous hyperhidrosie. Histological examination revealed marked hyperplasia, hypertrophy and cystic dilatations of eccrine sweat apparatus accompanied by proliferation of the capillary hemangiomatous component and ectopic, thick smooth muscle bundles in the deep dermis and subcutaneous tissue.
Adolescent ; Capillaries ; Dermis ; Dilatation ; Female ; Hamartoma* ; Humans ; Hyperplasia ; Hypertrophy ; Leg ; Muscle, Smooth ; Subcutaneous Tissue ; Sweat ; Sweating

Most insects including the honeybee cause erythema and edema at the site of a sting in non-allergic individuals. This reaction usually resolves within a few days. However, in certain cases, the persistence of inciting materials in the cutaneous tissue may promote a local inflammatory foreign body reaction. Localized nodular lesions were seen in our two patients and erythemstous patches were present in one patient due to rarely encountered complications induced by retained sting materials. In these cases histopathology showed multiple foci of foreign body granuloma containing yellow refraetile material in the center surrounded by histiocytes and foreign body giant cells. The granulomatous skin lesions in these patients were treated with intralesional injections of triamcinolone acetonide and partial excisions of the nodular masses were performed.
Bites and Stings ; Edema ; Erythema ; Foreign-Body Reaction ; Giant Cells, Foreign-Body ; Granuloma* ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Injections, Intralesional ; Insects ; Skin ; Triamcinolone Acetonide