BACKGROUND: Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended toreview the effect of adolescents smoking an the drug abuse and deviated behaviors. METHODS: On September, 1997, randomly selected were 12 classes, an the basis of 2 classes per grade, from the two schools which was located each in Seoul and Buchean. And survey was dane on 610 students with non non-nominl, self-reported questionnaire. RESULTS: The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st gade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nansMoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also simihr results were shown in deviated behaviors between the groups. CONCLUSIONS: With the concerted efforts of family, school, society and natian, we as family physicians should make efforts to delay and prevent adolescent's smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Adhesives ; Adolescent ; Critical Period (Psychology) ; Female ; Humans ; Hypnotics and Sedatives ; Korea ; Male ; Physicians, Family ; Salaries and Fringe Benefits ; Seoul ; Smoke* ; Smoking* ; Street Drugs ; Substance-Related Disorders* ; Tobacco Products ; Surveys and Questionnaires

A solid pseudopapillary tumor is a rare pancreatic tumor with a low malignant potential that occurs commonly in young females. We report a case of 12-year-old girl with a solid pseudopapillary tumor of the pancreas associated with symptoms of anemia. She was suspected to have a 7x4.5 cm mass growing from the head of the pancreas based on an esophagogastroduodenoscopy, a radiological imaging study, and an immunohistochemical stain examination. She was finally diagnosed with a solid pseudopapillary tumor after a pancreaticoduodenectomy as the definitive treatment.
Anemia ; Child ; Endoscopy, Digestive System ; Female ; Head ; Hemorrhage ; Humans ; Pancreas ; Pancreaticoduodenectomy

Biliary-enteric fistula is a rare disease, and the common causes of biliary-enteric fistula are gallstone, peptic ulcer, malignancy and trauma. It is known that the most common type of biliary-enteric fistula is the cholecysto-duodenal fistula, yet the combination of choledocho-duodeno-colonic fistula is a rare finding. A 78-year-old woman was admitted because she had suffered with right upper quadrant pain, a febrile sense and chills for 2 days. We confirmed the choledocho-duodeno-colonic fistula by performing gastroduodenoscopy, abdominal CT and an upper GI series. So, we report here on an usual case of choledocho-duodeno-colonic fistula, along with a review of the relevant literatures.
Aged ; Biliary Fistula ; Chills ; Female ; Fistula* ; Gallstones ; Humans ; Peptic Ulcer ; Rare Diseases ; Tomography, X-Ray Computed

PURPOSE: Mycoplasmal pneumonia is one of the most common respiratory diseases in childhood, and is increasing in frequency. We reviewed several aspects of Mycoplasmal pneumonia for applying treatment. METHODS: We reviewed clinical and radiological features of 79 cases of serologically proven Mycoplasmal pneumonia in admitted children between January and December 2003. RESULTS: The mean age was 4 years 2 months and the sex ratio was 1: 1.25 in the male to female ratio. The peak incidence of monthly distribution was September. On the chest x-ray examination, bronchopneumonia was the most common type and the right lower lobe (RLL) was the most common unilateral involvement in lobar consolidation. Leukocytosis, positive CRP and positive ESR were common findings in Mycoplasma pneumonia. CONCLUSION: In this study, peak incidence of monthly distribution did not conflict with previous reports but peak incidence of age in Mycoplasmal pneumonia was lower than in those reports. More studies are needed to prove changes of previous manifestations in Mycoplasmal pneumonia.
Bronchopneumonia ; Child* ; Female ; Humans ; Incidence ; Leukocytosis ; Male ; Pneumonia* ; Pneumonia, Mycoplasma ; Sex Ratio ; Thorax

PURPOSE: The object of this study was to determine the shortest possible distances of antero-medial (AM) and postero-lateral (PL) guide wire tunnel positions required to prevent femoral bone tunnel communication in double-bundle anterior cruciate ligament (ACL) reconstruction using human cadaver knees. MATERIALS AND METHODS: The centers of femoral AM and PL bundles of 16 cadaveric knees were drilled with guide wires and the distances of guide wires, were measured upon entrance into the bone. Femoral tunnel drilling was performed using transportal technique. The diameters of AM and PL graft were 8 mm and 6 mm, respectively. CT scans were taken on each knee, and 3-dimensional models were constructed to identify the femoral tunnel position and to create AM and PL tunnel virtual cylinders. Thickness of the bone bridge between the two tunnels was measured. RESULTS: In four out of six specimens, in which the guide wires were placed at less than or equal to 9 mm, communication was noted. In specimens with guide wires placed at distances greater than or equal to 10 mm, communication was not noted. The two groups showed a statistically significant difference (p=0.008). In cases where the distance between the AM and PL femoral tunnel guide wires was 12 mm, the bone bridge thickness was greater than 2 mm along the tunnel. CONCLUSION: The technique for double bundle-anterior cruciate ligament (DB-ACL) reconstruction that we show here can avoid bone tunnel communication when AM and PL femoral guide wires are placed at least 10 mm apart, and 12 mm should be kept to preserve 2 mm bone bridge thickness.
Aged ; Anterior Cruciate Ligament/*anatomy & histology/surgery ; Anterior Cruciate Ligament Reconstruction/*methods ; *Bone Wires ; Cadaver ; Female ; Femur/*anatomy & histology/surgery ; Humans ; Knee Joint/surgery ; Male ; Middle Aged ; Tibia/*anatomy & histology/surgery ; Tomography, X-Ray Computed

Purpose: : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods: : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results: : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

BACKGROUND/AIMS: The reappearance rates of hepatitis C virus (HCV) RNA after a sustained virological response (SVR) have been reported to be 1-2%. We investigated the reappearance rate of HCV RNA after SVR in chronic hepatitis C (CHC) patients treated with pegylated interferon (PEG-IFN) and ribavirin. METHODS: In total, 292 CHC patients who achieved an SVR after PEG-IFN and ribavirin treatment were included. They were treated with subcutaneous injections of either PEG-IFN-alpha 2a or 2b plus ribavirin orally. Liver function tests and qualitative HCV RNA assays were performed every 6 months during the follow-up period after an SVR. RESULTS: Among the 292 patients, 224 (genotype 1, 92; genotype non-1, 132) were followed up for more than 6 months after SVR. These 224 patients were aged 48.1+/-11.5 years (mean+/-SD), and 129 of them were male. The median follow-up duration was 18 months (range 6-60 months). The reappearance rate of HCV RNA during follow-up was 0%. Two patients who achieved an SVR developed hepatocellular carcinoma during the follow-up period. CONCLUSIONS: An SVR was maintained in all CHC patients treated with PEG-IFN plus ribavirin during a median follow-up of 18 months. However, a screening test for hepatocellular carcinoma is needed for patients with an SVR.
Adult ; Antiviral Agents/*therapeutic use ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Genotype ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon-alpha/*therapeutic use ; Liver Function Tests ; Male ; Middle Aged ; Polyethylene Glycols/*therapeutic use ; RNA, Viral/analysis ; Recombinant Proteins/therapeutic use ; Ribavirin/*therapeutic use

A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion.
Biopsy, Needle* ; Humans ; Hypersensitivity, Delayed ; Lung ; Middle Aged ; Needles* ; Pleural Effusion* ; Pleurisy ; Rupture ; Solitary Pulmonary Nodule* ; Tuberculosis, Pulmonary

The Inhalation of certain freshly formed metal oxides can cause metal fume fever, which is an acute, self-limiting, flu-like illness. The most common cause of this syndrome is the inhalation of zinc oxide. The inhalation of zinc oxide can lead to tracheobronchiolitis, chemical pulmonary edema or to respiratory failure and acute respiratory distress syndrome(ARDS). We encountered a 43-years-old man who developed severe dyspnea after inhaling of zinc oxide while working for 5 hours in a closed space. He was diagnosed with ARDS and was treated successfully with glucocorticoid. We report a case of ARDS caused by the inhalation of zinc fumes.
Acetylcysteine ; Dyspnea ; Fever ; Inhalation* ; Oxides ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Zinc Oxide ; Zinc*

BACKGROUND AND OBJECTIVES: Drug-induced electrocardiographic QT interval prolongation is associated with the occurrence of a potentially lethal form of polymorphic ventricular tachycardia, termed 'torsades de pointes' (TdP). Women are at greater risk for the development of drug-induced TdP. To determine whether this may be the result of gender-specific differences in the effect of quinidine on cardiac repolarization, we compared the degree of quinidine-induced QT interval lengthening in young, healthy volunteers. SUBJECTS AND METHODS: Twelve women and 12 men each received a single intravenous dose of quinidine (4 mg/kg) or placebo in a single-blinded, randomized crossover trial. Total plasma concentrations of quinidine were measured, and QT and corrected QT intervals were analyzed. RESULTS: As expected, the mean QTc interval at baseline was longer for women than for men (443.6+/-26.9 vs 402.1+/-31.3 msec, respectively, p=0.037). The mean value of the maximal DeltaQTc after quinidine infusion was higher in women (134.4+/-46.4 vs 117.5+/-37.7 msec, respectively, p=0.029), and the mean value of the minimal DeltaQTc for 1 hour after quinidine infusion was also higher in the female group (47.6+/-15.7 vs 83.7+/-25.4 msec, p=0.034). However, there were no significant differences in the time courses of the changes in the quinidine-induced QTc and DeltaQTc interval between the two groups (p=0.092, and p=0.305, respectively). CONCLUSION: Quinidine causes greater QT prolongation in women at equivalent serum concentrations. This difference may contribute to the greater incidence of drug-induced TdP observed in women taking quinidine, and has implications for other cardiac and noncardiac drugs that prolong the QTc interval.
Asian Continental Ancestry Group ; Electrocardiography ; Female ; Healthy Volunteers ; Humans ; Incidence ; Male ; Plasma ; Quinidine ; Tachycardia, Ventricular