No abstract available.
Child ; Health Promotion ; Humans ; Immunization* ; Child Health

Acquired hemophilia A (AHA) is a rare bleeding disorder, especially in adolescents and young adults (AYAs) attributable to the development of autoantibodies against coagulation factor VIII (FVIII). AHA diagnosis is difficult; patients lack any history of coagulopathy. We report here on an AYA with AHA who responded well to treatment. A 19-year-old woman visited our hospital with painful swelling of the right lower leg. She had no past or familial history of a bleeding disorder. The initial laboratory data revealed a prolonged activated partial thromboplastin time and an uncorrected mixing test result. The FVIII activity was below 1% and the FVIII antibody level 22.4 Bethesda units. She was diagnosed with AHA and treated with recombinant activated coagulation factor VII, activated prothrombin complex concentrates and an oral steroid. After 9 months, FVIII antibody level was negative and the FVIII activity was normalized. AHA is very rare especially in AYAs, but physicians must be suspicious about the disorder and plan specialized coagulation tests to diagnose the disease. An early diagnosis of acquired bleeding disorders should be done for initiating the adequate treatment immediately by both controlling the acute bleeding episode and eliminating FVIII antibodies.

Inhibitor development is one of the major adverse events associated with increased morbidity and mortality in patients with congenital hemophilia. Recent treatment for them is immune tolerance induction (ITI), which involves the administration of high doses of factor concentrates over a prolonged period, sometimes combined with immunosuppressive agents. We report a case of inhibitor elimination with Rituximab, and high-dose factor VIII concentrates in a 5-year-old boy with hemophilia A. The patient improved clinically, with fewer bleeding episodes. However, he continued to have low immunoglobulin levels, which led to recurrent infections. After an infusion of intravenous immunoglobulin, inhibitor titers increased rapidly and his ITI was deemed a failure. In conclusion, even though it failed in the present study, Rituximab may be an alternative adjuvant therapy to eliminate the inhibitor in patients with hemophilia. The appropriate schedule and long-term side effects need further investigation.
Appointments and Schedules ; Child, Preschool ; Factor VIII ; Hemophilia A ; Hemorrhage ; Humans ; Immune Tolerance ; Immunoglobulins ; Immunosuppressive Agents ; Male ; Mortality ; Rituximab

PURPOSE: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. METHODS: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. RESULTS: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. CONCLUSIONS: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.
Bone Resorption ; Dental Implants ; Dentistry ; Durapatite ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Osteogenesis ; Transplants

OBJECTIVES: Despite the importance of human immunodefi-ciency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. METHODS: 169 HIV-infected males and their female sex partners were recruited from 1985 to June 1998. We examined female sex partners HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. RESULTS: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell counts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) CONCLUSION: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.
Cell Count ; Condoms ; Family Characteristics ; Female* ; Heterosexuality* ; HIV Infections ; HIV* ; HIV-1 ; Humans ; Korea* ; Male* ; Multivariate Analysis ; Risk Factors* ; RNA

The effects of nutrition label education on the perception, nutrition knowledge, understanding and applicability of labeling for 81 5th grade students was assessed. Prior to the education, the students' purchasing behavior of processed food was assessed by self-administered questionnaires. The evaluation of subjects' perception and understanding on nutrition label was completed prior to and following four education sessions utilizing materials developed by Korea Food and Drug Administration and Korea Health Industry Development Institute. More than 90% and 15% of subjects purchased processed food weekly and daily, respectively. Considering the nutrition label became an important factor in food purchases following the education sessions. Perception of the value of nutrition label improved from 2.93 to 3.32, although the belief that nutrition labels contributed to the maintenance of good food intake was not significantly increased. The total nutrition knowledge score increased from 5.47 to 7.14 and understanding nutrients composition table was significantly improved (3.17 to 4.80). The results indicate that a school-based nutrition label education program might be an effective aid for adoption of healthier food choices by children.
Adoption ; Child ; Eating ; Humans ; Korea ; Surveys and Questionnaires ; United States Food and Drug Administration

PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.
Home Care Agencies ; Home Care Services ; Long-Term Care ; Nursing Homes ; Quality Indicators, Health Care

BACKGROUND: Although sexuality in old women is important for the quality of life, that has been overlooked due to social indifference. Because the studies for sexuality in old women were lack in Korea, we surveyed sexuality and its influential factors in old women. METHODS: From March to July 2000, we surveyed 115 old women over 60 years with 22 items of questionnaire. Data was gathered through written responses to the questionnaire and one to one interview between doctor and subject. Statistical analysis was done with SPSS ver10.0/PC and its significance was tested by chi square(p<0.05). RESULTS: Mean age of 115 women is 64.84+/-4.54year. There are 80 cases(69.6%) that thought sexuality is important in old women. Sexuality and sexual interest get gradually decreased by aging. Marital state, age of husband, family structure, economic state, sexual interest are statistically significant as the influential factors of sexuality(p<0.05). Sexual satisfaction comes out 35.7%. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically signifiant as the influential factors of sexual satisfaction(p<0.05). The reasons of decreased sexuality is due to aging process(47.8%), no partner(17.4%), partner problem(14.8%), physical illness(10.4%) and decreased libido. CONCLUSION: We conclude that sexuality in old women is important. Its influential factors are marital state, age of husband, family structure, economic state, sexual interest. Age, marital state, family structure, job, economic state, subjective health state, current medication, sexual interest are statistically signifiant as the influential factors of sexual satisfaction.
Aging ; Female ; Humans ; Korea ; Libido ; Quality of Life ; Sexuality* ; Spouses ; Surveys and Questionnaires

This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5+/-9.6 for the males and 52.2+/-8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B1 and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B1, vitamin B2 and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation.
Aging ; Calcium ; Cholesterol ; Cohort Studies ; Education ; Energy Intake ; Female ; Humans ; Iron ; Male ; Nutritionists ; Postal Service ; Prospective Studies ; Riboflavin ; Seoul ; Sodium ; Telephone ; Thiamine ; Vitamin A ; Vitamins ; Volunteers

No abstract available.
Gram-Positive Cocci*