To determine the hepatitis B virus infection rate of medical school students and appropriate time for immunization with hepatitis B vaccine, 385 students in the 1st, 2nd and 3rd grades of Medical School of Kyungpook National University who had not been vaccinated and volunteered to participate in this study were tested for HBsAg, anti-HBs and anti-HBc with radioimmunoassay method (Abbortt Lab. kit). A questionnaire was administered to ask the history of transfusion, acupuncture and surgery. HBsAg positive students were retested 16 months after the initial test. Overall HBsAg positive rate was 6.8% and the age adjusted rate for male (7.2%) was higher than that for female (4.9%). Anti-HBs positive rate was 35.8% (36.1% for male, 37.9% for male) and anti-HBc positive rate was 45.5% (46.5% for male, 44.7% for femaleP. Overall hepatitis B virus (HBV) infection rats was 49.1% and the infection rate for male (50.3%) was slightly higher than that for female (46.5%). HBsAg positive rate and infection rate were increased as the grade increased but it was attributed to the age distribution of the students. HBsAg positive rate for 20 years old students was 1.7%; 21 years, 6.6%; 22 years, 6.1%; 23 years, 12.2%; and 24 years and older, 6.4%. HBV infection rate showed an increasing trend as age increased; 45.8% for 20 years, 41.5% for 21 years, 49.5% for 22 years, 55.5% for 23 years and 59.6% for 24 years and older. The age differences in HBsAg positive rates and HBV infection rates did not reach the statistical significance level of 0.05. However, these findings and similar age differences in HBsAg positive rates and HBV infection rates observed in other study suggest that there is a significant age differences. Study of the same age group in other schools and different social classes is warranted to confirm the age difference. Clarification of the reason for such differences would provide a clue to identify the major route of HBV transmission in this age group. Among 26 HBsAg positive students in the initial test, only one student was active hepatitis patient. Out of 24 students who had follow-up test after 16 months 22 students were positive for HBsAg and two students became HBsAg negative and anti-HBs positive. It is obvious that nearly one-half of the medical school students were infected with HBV before 20 years of age and the HBV infection occurs in medical school. Thus, it is recommended to test all the students for HBV infection soon after the admission to the medical school and immunize all the susceptible students with hepatitis B vaccine and give booster as they start to practice at a hospital.
Acupuncture ; Age Distribution ; Animals ; Daegu* ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Male ; Surveys and Questionnaires ; Radioimmunoassay ; Rats ; Schools, Medical* ; Social Class ; Young Adult

No abstract available.
Priapism* ; Ureter*

No abstract available.
Hospice Care ; Hospices

No abstract available.
Cystitis* ; Pyelonephritis*

No abstract available.
Edema* ; Hydrops Fetalis*

Monitoring fetal movement serves as an indirect rneasure of fetal well-being, especially for central nervous system integrity and function. Methods to monitor fetal movement vary from the simple approach of having the mother chart perceived movement to highly specialized methods. However there were no reliable objective monitoring methods in Korea. For development of objective method for evaluating fetal movement, during pregnancy, one-hundred and two pregnant patients were entered to this study. All patients were divided into following 3 groups and each type of monitoring methods were applied. Group 1(N=20): Type I using portable FHR Doppler unit(IFD-100 model, Intermed, Korea). Group 2(N=20): Type II using FHR Microphone(Prenatal Listening Kit, Model FS002, Unisar Inc., US). Group 3(N=62): Type III using conventional ultrasound transducer(Corometric 115 Model, US). In this study, accurate counting of the fetal movementutus were best performed using Type III, because of monitoring fetal movements has its greatest efficiency when using conventional ultrasound transducer of fetal monitor. It was also attractive to doctors and nurses as a convenient methods because it needed only single transducer when compared to Type I and II. Although monitoring fetal body movement permits a general assessment of well-being, no perfect technique is still reliable. Futher techniques would be developed using the results of this study for improvement of several factors such as accuracy and objectiveness
Central Nervous System ; Fetal Monitoring ; Fetal Movement* ; Humans ; Korea ; Mothers ; Pregnancy* ; Transducers ; Ultrasonography

BACKGROUND: Surgical closure of the PDA in premature infants with complications or contraindications to indomethacin use, or recurrence of symptomatic PDA is a safe and effective procedure with low operative risk and minimal complications. MATERIAL AND METHOD: From April 1996 to August 1998, 11 premature infants with body weight under 1.5 kg at operation underwent operation for a symptomatic PDA (male:5, female: 6). Associated dise ases were congenital heart disease(7), hyaline membrane disease(6), intraventricular hemor rhage(4), pneumonia(4), pneumothorax(3), hyperbilirubinemia(2), necrotizing enterocolitis(2), renal failure(1), epilepsy(1), and hydrocephalus(1). Surgical techniques are hemoclipping(8) and ligation(3). The size of PDA was 3~6 mm (5.0+/-1.2). RESULT: Systolic and diastolic blood pressure rised and heart rates decreased after PDA closure. ABGA improved postoperatively. There were no surgical complications. Six infants with improved ABGA data were weaned from mechanical ventilatory support. The follow-up durations after discharge were 3 month to 12 month. Five deaths were not related to operation. The causes of death were hyaline membrane disease(2), bronchopulmonary dysplasia with pneumonia(1), sepsis(1), and con gestive heart failure with respiratory distress syndrome(1). CONCLUSION: Early operative closure is the treatment of choice in most premature infants with a hemodynamically significant shunt(PDA), recurrence of symptomatic PDA, complications of Indomethacin, or contraindi cations to Indomethacin.
Blood Pressure ; Body Weight ; Bronchopulmonary Dysplasia ; Cations ; Cause of Death ; Ductus Arteriosus, Patent ; Female ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Rate ; Humans ; Hyalin ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Membranes ; Recurrence

Acute renal failure(ARF) usually has more than one cause and almost always includes an ischemic or nephrotoxic component to varying degrees. Regeneration and repair appear to be modulated by circulating and locally produced growth factors including insulin-like growth factors(IGFs). This study examined the change of serum and renal IGF-IGFBP axis in uremic rat by using IGF-I radioimmunoassay, Western ligand blot, immunohistochemical study and Northern blot analysis. Sera and kidney samples were obtained before and after 1, 3, 5, 7, 10 and 14 days of 45 minutes bilateral renal pedicle clamping. The results were as follows. 1) Following bilateral renal pedicle clamping, rats lost their weight, reaching a maximum after 3 days of ischemic injury. On day 10 uremic rats were still below their starting weights. 2) Following acute ischemic renal injury, serum creatinine rose, reaching a maximum after 3 days. By the 10th day serum creatinine levels had fallen to normal values. 3) Serum IGF-I concentration after 1 day following ischemic injury was significantly decreased compared to preischemic value. However the decreased level was returned to normal value after 3 days of ischemic injury. 4) The alteration of serum IGFBP profiles was observed in uremic rat. The 37-45 kDa sized IGFBP (probably IGFBP-3) was increased after 3 days of ischemic renal injury and continued until 10 days of ischemic injury. Another 28 kDa sized IGFBP also increased after 3 days of ischemic injury. 5) In preischemic kidney, immunoreactive IGF-I were primarily present in cortical tubule. However, IGF-I was markedly decreased on day 3 uremic rat. 6) IGFBP-3 and -7 mRNA in uremic kidney were temporally decreased on day 1 but increased to normal or higher levels after 3 days of ischemic renal injury. IGFBP-1 and -4 mRNA were markedly increased after 1 day and maintained high levels until 5 days(IGFBP-1) and 14 days(IGFBP-4) of ischemic renal injury. These findings suggest that IGF-IGFBP axis may involve in the pathogenesis or the recovery from acute renal failure.
Acute Kidney Injury* ; Animals ; Axis, Cervical Vertebra ; Blotting, Northern ; Constriction ; Creatinine ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins* ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Kidney ; Radioimmunoassay ; Rats* ; Reference Values ; Regeneration ; RNA, Messenger ; Weights and Measures

The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs shuld provide the GPs with a continuing education to assist the problem solving in the field and motivate them to activitely carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.
Bandages ; Clinical Competence ; Education* ; Education, Continuing ; Emergencies ; Gyeongsangnam-do ; Health Personnel ; Health Services ; Hospitals, General ; Humans ; Insurance ; Maternal Health ; Postal Service ; Problem Solving ; Specialization ; Teaching ; Wounds and Injuries

PURPOSE: Nutritional as well as genetic and hormonal factors play an important role in the bone mineralization during childhood and adolescence. There are several physical and metabolic changes in obese children, and these changes may influence on the mineralization of the skeleton. The studies about bone mineralization of obese children are rare and contradictory. This study was performed to evaluate the influence of childhood obesity on bone mineral density(BMD). METHODS: The BMD of 49 obese and 41 non-obese children were measured at lumbar spines(L2-L4) using dual energy X-ray bone absorptiometry. Then, the results were assessed and compared according to the degree of obesity and pubertal sex maturation. RESULTS: There were no significant differences in BMD between obese children and non-obese children(0.87+/-.19 g/cm2 vs 0.81+/-.13 g/cm2). BMD increased according to the Tanner' pubertal staging, and the most marked increment was observed at overt puberty. No sex difference in BMD was seen in both obese and non-obese children. BMD was highly correlated with age, height, weight and body mass index(BMI), but there was no significant correlation between BMD and osteocalcin. CONCLUSION: BMD of obese children was not significantly different from that of non-obese children, and BMD also was not changed according to the degree of obesity. These findings suggest that BMD is not influenced by obesity in children.
Adolescent ; Bone Density* ; Calcification, Physiologic ; Child* ; Humans ; Obesity* ; Osteocalcin ; Pediatric Obesity ; Puberty ; Sex Characteristics ; Sexual Maturation ; Skeleton