The auther observed 51 cases of diphtheria admitted to the Department of Pediatrics and E.N.T. of Chonnam University Medical School Hospital from Jan. 1970 to June 1975. The highest seasonal incidence was from November to February, and the age incidence was highest in the 4 to 9 year range with the sex ratio of male 1.5 to female 1. 62.7% of the patients were laryngeal and 35.3% were pharyngeal in type of the disease. Most of the patients admitted to the hospital 5 days after the symptoms manifested. The presenting complaints were in sequence of dyspnea(84.3%), restlessness (78.4%), High fever (64.7%), cough(62.7%) and hoarseness (60.8%). The pseudomembrane was detected in 54.9% of the cases, and 52.9% of the case revealed positive results on the smear preperations taken from nasopharynx. On the peripheral blood counts, 75.6% of the patients had mild to moderate degree of anemia and 81.8% of the cases showed leukocytosis. The electrocardiogram obtained at the time of admission revealed abnormality in 54.5% of the cases. As complications, proteinuria (27.4%), myocarditis (5.8%), bullneck (5.8%), palatal paralysis (1.9%) and phrenic nerve paralysis (1.9%) were detected. 9 cases (17.6%) were expired, 6 of those were laryngeal type and other 3 were pharyngeal type.
Anemia ; Diphtheria* ; Electrocardiography ; Female ; Fever ; Hoarseness ; Humans ; Incidence ; Jeollanam-do ; Leukocytosis ; Male ; Myocarditis ; Nasopharynx ; Paralysis ; Pediatrics ; Phrenic Nerve ; Proteinuria ; Psychomotor Agitation ; Schools, Medical ; Seasons ; Sex Ratio

Surveying 2741 children (boys 1416, girls 1325) in Chonnam Area, Korea anthropometrically with mixed longitudinal method from 1973 to 1976 showed that weights of children were closer to the Korean Standards than heights of them. Hematological examinations to 1303 children(boys 640, girls 663) including hemoglobin, hematocrit and total serum protein revealed lower limits of normal values respectively. Percentiles charts ofr heights and weights in school children of both sexes were illustrated.
Child* ; Female ; Hematocrit ; Humans ; Jeollanam-do* ; Korea* ; Reference Values ; Weights and Measures

No abstract available.
Stomach Neoplasms* ; Stomach* ; Water*

Acute suppurative cholangitis is a severe inflammatory process of the bile duct occurred as a result of partial or complete obstruction of the bile duct, and may manifest clinically severe from of disease, rapidly deterioration to life-threatening condition. We analyzed emergency percutaneous transhepatic biliary drainage in 20 patients of acute suppurative cholangitis with biliary sepsis to evaluate the therapeutic effect and complication of the procedure. The underlying causes were 12 benign diseases(stones) and eight malignant tumors and among eight malignant tumors, bile duct stones(n=4) and clonorchiasis (n=1) were combined. Percutaneous transhepatic biliary drainage was performed successfully in 17 of 20 patients improvement of general condition and failed in three patients. The procedures were preterminated due to the patient's condition in two and biliary-porto fistula was developed in one. After biliary decompression by percutaneous transhepatic biliary drainage, effective and successful elective surgery was performed in nine cases, which were seven biliary stones and two biliary cancer with stones. Our experience suggests that emergency percutaneous transhepatic biliary drainage is an initial and effective treatment of choice for acute suppurative cholangitis with sepsis and a safe alternative for nonsurgical treatment.
Bile Ducts ; Cholangitis* ; Clonorchiasis ; Decompression ; Drainage* ; Emergencies ; Fistula ; Humans ; Sepsis*

Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewedconventional radiographies and CT from Histopathologically confirmed 30 cases of spinal tuberculosis, and comparedthese findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of meastasis. The resultswere as follows: 1. The frequnet site of involvement were thoracolumbar juntion and low lumbar vertebrae, and themost frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the diferentaldiagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral bodydestruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containingcalcification and disc space narrowing, in the setting of an indolent or relatively benign course. 3. CT is thebest modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, andthe change of adjacent vital structure. So CT was particularily useful in pre-operative planing of debridement andstabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were thecompression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in thespinal canal.
Abscess ; Debridement ; Early Diagnosis ; Granulation Tissue ; Lumbar Vertebrae ; Neurologic Manifestations ; Spinal Cord ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

We retrospectively evaluated the characteristic computed tomographic (CT) findings in nine patients with exohepatic hepatocellular carcinoma(HCC) pathologically prove by surgery(n=2) or percutaneous needle biopsy(n=7). The CT findings of exohepatic HCC were correlated with clinical findings and compared with those of usual HCC Lesions were in the left lobe lobe(n=7) and right lobe(n=2) of the liver. All lesions showed a well-marginated hypodense mass with capsular enhancement on enhanced CT scan. The patterns of capsular enhancement were complete in five and partial in four cases. The portal vein thrombosis was seen only in one case. There was no difference between exohepatic HCC and usual HCC in clinical findings such as increased α-fetoprotein(α-FP), positive Hepatitis B surface antigen(HBsAg), and underlying liver cirrhosis. In conclusion, the CT findings of exohepatic HCC were a well-defined hypodense mass with complete or partial capsular enhancement and these findings may be useful in differentiation from the tumors of adjacent organs.
Carcinoma, Hepatocellular* ; Hepatitis B ; Humans ; Liver ; Liver Cirrhosis ; Needles ; Retrospective Studies ; Tomography, X-Ray Computed ; Venous Thrombosis

BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitations of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric antibiotic regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. METHODS: Medical records of adults (> 15 years of age) hospitalized for CAP or pulmonary tuberculosis between March 1995 and February 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer to "atypical" pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum with compatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinical response to anti-tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of respiratory pathogens from all body sites, and their clinical significance were evaluated. RESULTS: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria, 246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171 (71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44 (18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococcal streptococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable : E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae, and A. baumannii and K. pneumoniae), S. aureus (2 definite and 2 probable), and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8 isolates). The rates of admission to the intensive care unit and of using assisted ventilation were 18% and 9.3% respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but all seven isolates from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolates of K. pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. CONCLUSION: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test to "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which will be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.
Adult ; Anti-Bacterial Agents ; Anti-Infective Agents ; Cefotaxime ; Chungcheongnam-do ; Coinfection ; Diagnosis ; Fever ; Gentamicins ; Haemophilus ; Hospitals, University* ; Humans ; Hypothermia ; Incidence ; Influenza, Human ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Male ; Medical Records ; Mortality ; Mucormycosis ; Mycobacterium ; Mycobacterium tuberculosis ; Mycoplasma ; Penicillins ; Pneumonia* ; Prospective Studies ; Seoul ; Serologic Tests ; Sputum ; Streptococcus pneumoniae ; Tachypnea ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary ; Ventilation

BACKGROUND: As of 30 September 2001, a total of 1,515 human immunodeficiency virus(HIV) infected persons has been reported in Korea. The number of newly infected persons tends to increase year by year, with the result that the contacts between HIV infected persons and health care workers (HCW) become more frequent. This survey was to investigate the current state of occupational HIV exposure and postexposure management among HCW in Korea. METHODS: We surveyed retrospectively the cases of occupational HIV exposure reported until the first half of 2001, in total 14 tertiary teaching hospitals. We reviewed these cases for the details about ; i) exposure type. medium and depth of injuty, ii) postexposure prophylaxis(PEP) and follow up serologic test and iii) source patients. RESULTS: Forty-eight cases(65% female, no pregnant woman) of occupational HIV exposure were identified. The number of cases tends to increase rapidly in recent two years. The majority of the exposure occurred in nurses and doctors, after percutaneous needle stick injury. The mean time from exposure to administration of PEP drugs was 20 hours. Of 39 cases receiving the PEP drug, 62% completed all of the drugs as initially prescribed and 31% discontinued all PEP drugs. The reasons for discontinuation included adverse events(9 cases), health care provider judgment(1case), and source patient HIV negative(1case). There was at least one adverse event in 59% of cases receiving the PEP drugs. The most frequent adverse events were gastrointestinal symptoms such as nausea. vomiting, anorexia, and indigestion. So far. there has been no HCW infected with HIV via occupational exposure. Conelusion: Although primary prevention remains the best strategy for protecting HCW from occupational HIV transmission, exposures are nevertheless likely to occur. Systematized PEP programs that include written protocols for prompt reporting, evaluation, counseling, treatment. and follow-up of occupational exposures will be needed for the secondary prevention.
Anorexia ; Counseling ; Delivery of Health Care* ; Dyspepsia ; Female ; Follow-Up Studies ; Health Personnel ; HIV* ; Hospitals, Teaching ; Humans ; Korea* ; Nausea ; Needles ; Occupational Exposure ; Primary Prevention ; Retrospective Studies ; Secondary Prevention ; Serologic Tests ; Vomiting

With the increasing proportion of elderly and diabetic dialysis patients, permanent dual lumen catheters are becoming popular. One of the most frequent causes for the failure of hemodialysis in CRF patients with the tunneled cuffed catheter is the catheter dysfunction. It is thought to be due to encasement of the catheter by fibrin sleeve or fibrin sheath, kinking or malposition of the catheter. Catheter dysfunction due to fibrin sheath formation could sometimes be managed by reversal of arterial and venous lines, urokinase lock or infusion, and catheter exchange. Recently percutaneous fibrin sheath stripping (PFSS) became another modality of salvaging failing tunneled cuffed catheter before attempting catheter exchange. There was no report of applying PFSS to salvage the permanent dual lumen catheter in Korea. Authors recently experienced a case of successful application of PFSS to extend the life of catheter in a CRF patients as a last resort after failure of repeated urokinase trials. It is thought that PFSS is a simple and effective procedure which extends the longevity of permanent dual lumen catheter.
Aged ; Catheters* ; Dialysis ; Fibrin* ; Health Resorts ; Humans ; Korea ; Longevity ; Renal Dialysis ; Urokinase-Type Plasminogen Activator