This study was conducted to evaluate the effect of prolonged treatment in children with chronic hepatitis B with combination of alpha-interferon and acyclovir. The study population consisted of 7 patients with chronic hepatitis B who showed histological findings compatible with chronic active hepatitis (4 cases) or chronic persistent hepatitis (3 cases) on liver biopsy and had elevated AST and ALT with positive HBsAg, HBeAg and HBV-DNA for more than 6 months. Recombinant interferon-alpha-2 was given in a dose of 3 million IU/m2 daily for 3 months with acyclovir in a dose of 15mg/Kg of body weight every 12 hours for 7 days of each month for 3 months. Then, the same dose of interferon was given thrice a week for 9 more months. One patient who had vertically transmitted hepatitis B from her mother had received only 6 months of treatment in total as she did not show any effect after 6 months of treatment. Among 6 patients who had positive HBV-DNA on entry to the study, 4 patients (66.7%) showed conversion of HBV-DNA to negative. HBeAg was converted to negative in 3 patients (42.9%). AST and ALT became normal in 6 cases but HBsAg remained positive in all cases. prolonged treatment in children with chronic hepatitis B with combination of alpha interferon and acyclovir seems to be beneficial but the proper dosage and duration of therapy need to be determined with further and controlled study.
Acyclovir* ; Biopsy ; Body Weight ; Child* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver ; Mothers

BACKGROUND: Cosmetics are one of the common causes of contact dermatitis and many new cosmetic products are being introduced rapidly into our market. OBJECTIVE: Our purpose was to investigate the as is patch test result by several factors including age, cosmetic product and atopic diseases, and to compare as is patch result with those of standard and cosmetic patch tests. METHODS: The records of 240 patients were reviewed who had been patch tested with their own cosmetics and toiletries with a clinical impression of cosmetic contact dermatitis at the patch clinic of Kangnam St. Mary's Hospital in the period of 1991-1995. RESULTS: Of the 95 patients who were tested with European standard series 54 (56.8%) showed a positive reaction and nickel sulfate was the most common allergen. Eighteen (38.3%) of the 47 patients tested with a cosmetic series revealed a positive reaction and imidazolidinyl urea and dodecyl gallate were the most common allergens. In as is patch test, 99 (41.3%) of the 240 patients showed a positive reaction to 248 (7.3%) of the 3403 cosmetics. Common cosmetic products showing positive reactions were skin care products (26.2%), face make-ups (19.8%), and hair preparations (16.9%). There was no statistically significant difference in the positive reaction rate between atopy and non-atopy patients. The positive correlation rate of as is test with standard and cosmetic series was relatively low. CONCLUSION: Commercial standard patch test series including cosmetic series are not enough to detect causative allergen in cosmetic contact dermatitis. As is patch test should be encouraged to detect new allergens, because many cosmetic ingredients are developed and introduced in market.
Allergens ; Dermatitis, Contact* ; Hair Preparations ; Humans ; Nickel ; Patch Tests* ; Skin Care ; Urea

No abstract available.
Blood Transfusion* ; Female ; Humans

BACKGROUND : The proportion and absolute number of older patients admitted through the emergency department (ED) are increasing yearly. As people getting older, they are more likely to suffer from emergency situation of disease, disability, and trauma. Combining with the decrease in physiologic reserve, these added burdens make the elderly more vulnerable to any of the additional situations. Understanding the implications of these facts is crucial to one who is providing optimal triage and emergency care to elderly (aged 65 years or older) and adults (between 15year of age and 64 years of age). METHODS : We conducted an observational survey of emergency patients age 15 or older who admitted to emergency department of Asan Medical Center. A convenience sample of 3,481 were divided into 2 groups by 65 years of age, and final results (admission vs. discharge) after emergency care was compared. The admission rate according to between two groups. We calculated odds ratios of important outcomes by pooling data from individual trials using logistic regression analysis. RESULTS : Admission rate of elderly was higher than adults as 59.2% versus 36.4% (odds ratio=2.32) 95% CI=1.21~3.24). Although vital signs were within normal ranges, admission rate of elderly was significantly higher than adults as follows; normal range of systolic blood pressure (56.0% vs. 35.5%), normal range of respiration rate per minute (55.4% vs. 36.4%), alert status of mentality (34.2% vs. 54.7%). CONCLUSION : We could not define the severity of emergency patients only by using vital signs and/or clinical symptoms, especially to the elderly patients. Even though the vital signs of elderly patients. emergency physician should manage them carefully because of the high severity of clinical condition in elderly then we expected. Emergency Geriatric Assessment tools must be developed differently from general triage tools.
Adult ; Aged* ; Blood Pressure ; Chungcheongnam-do ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Geriatric Assessment ; Humans ; Logistic Models ; Odds Ratio ; Reference Values ; Respiratory Rate ; Triage ; Vital Signs

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

BACKGROUND: Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction(AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. METHOD AND RESULTS: Seventy-one patients with AMI (47 male, 59+/-11 years) and 45 patients with normal coronary artery (29 male, 52+/-11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. CONCLUSION: cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI.
Arterial Pressure ; Chest Pain ; Coronary Vessels ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Mass Screening* ; Mitral Valve Insufficiency ; Myocardial Infarction* ; Relaxation ; Ventricular Function

No abstract available.
Pulmonary Atelectasis*

Cortex mori (Morus alba L.: Sangbaikpi), the root bark of mulberry tree, has been used as an antiphlogistic, diuretic, and expectorant in herbal medicine. Previous studies have demonstrated that the phenolic extract of Cortex mori have hypotensive, hypoglycemic, antifungal, antiviral, antiinflammatory, and anticancer effects, and the hot water extract from Cortex mori has inhibitory effects on compound 48/80- induced mast cell degranulation and histamine release from rat peritoneal mast cells (RPMCs). This study was perforrned to investigate the effects of polysaccharide fraction from Cortex mori (PFCM) on compound 48/80-induced degranulation, histamine release, calcium influx, changes of intracellular cAMP and cGMP level, and morphological changes of RPMCs. The results were summarized as follows. 1) Compound 48/80-induced cytomorphological changes such as swelling, degranulation, intracellular vacuoles, and interrupted cell boundary were significantly inhibited by pretreatment with either hot water or polysaccaride fractions frorn Cortex mori (PFCM), 2) the compound 48/80-induced histamine release from RPMCs pretreated with PFCM was significantly inhibited, compared to that of control without PFCM pretreatment, 3) the PFCM inhibited remarkably the compound 48/80-induced calcium influx into the RPMCs, 4) the PFCM increased significantly the intracellular cAMP levels and decreased the intracellular cGMP levels of RPMCs, compared to those of normal control, and 5) the compound 48/80-induced cAMP levels of RPMCs pretreated with PFCM were significantly increased, compared to those of positive control without PFCM, and the compound 48/80-induced cGMP levels of RPMCs pretreated with PFCM were remarkably decreased, compared to those of positive control without PFCM. From the above results, it is suggested that PFCM have an activity to inhibit the compound 48/80-induced mast cell activation.
Animals ; Calcium ; Herbal Medicine ; Histamine Release ; Mast Cells* ; Morus ; Phenol ; Rats ; Trees ; Vacuoles ; Water

PURPOSE: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. METHODS: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. RESULTS: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. CONCLUSION: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.
Cross-Sectional Studies ; Korea ; Public Health*

No abstract available.
Neurothekeoma* ; Scalp*