BACKGROUND: Korea is, known to be an endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Hower, not all people respond to hepatitis B immunsation. 5-15% of primary vaccinees fail to be immunized. After revaccination, only 37.5 44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccination in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation. METHODS: Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performed at 1 to 3 months after vaccintion. RESULTS: 17 healthy nanreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64), AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%). CONCLUSIONS: Nonresponders to Hepatitis B vaccintion respond well to double dose vaccination once.
Aged ; Antibody Formation ; Deltoid Muscle ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary ; Infant, Newborn ; Korea ; Mothers ; Smoke ; Smoking ; Vaccination*

No abstract available.

Opacification of the gallbladder after parenteral administration of contrast material usually indicates diminished renal function but can occur with normal renal function. The authors recently experienced 13 cases of such vicarious excretion of contrast media. Among 13 patients. 9 patients had renal disease unilateral ureteral stone(n=3), staghorn calculi(n=2), acute renal failure from sepsis(n=1), renal contusion(n=2) and unilateral renal artery involvement by dissecting aortic aneurysm(n=1). Of these 9 patients, 3 patients showed abnormal serum creatinine levels at the time of presentation or shortly thereafter. In 6 patients, injection of a large amount of contrast media was possibly the additional cause of vicarius excretion. There was no detectable cause in the remaining 4 patients. Heterotopic excretion of contrast media is clearly a complex phenomenon, the reason for which it is difficult to establish with certainty in each individual case. Anyhow, vicarius excretion of contrast media occurs more frequently than previously thought, and it can occur not only with abnormal renal function but with normal function also.
Acute Kidney Injury ; Contrast Media ; Creatinine ; Gallbladder* ; Humans ; Renal Artery ; Ureter

PURPOSE: Classically air in the portal vein has been detected on plain radiography, but computed tomography and ultrasonography have been shown to be more sensitive. We report a case of air in the PV in a 10-day-old infant with pneumatosis intestinalis with its ultrasonographic and Doppler findings. MATERIAL AND METHODS: The patient was a 10-day-old infant born by cesarean section at 41 weeks. Simple abdomen film revealed branching pattern of radiolucent air shadows within the contour of liver, gas distention of bowel loops and thickenod bowel walls with lincar intraluminal air shadows in abdomcn, suggesting neerotizing enterocolitis. So we performed Doppler ultrasonography. RESULTS: Ultrasonography showed branching pattern of hyperechogenic dots along the lumen of left portal vein. The color Doppler study revcaled an aliasing duo to increased velocity and whirling pattern of blood flow, and the Duplex Doppler spectral display showed sharp, vertical bidirectional spikes by air in portal vein. CONCLUSION: Air in the portal voin can be easily diagnosed by the followign signs:hyperechogenic dots in the portal vein on ultrasonography and vertical, sharp bidirectional spikes superimposod on the usual Doppler tracing of the portal vein on Duplex ultrasonography.
Abdomen ; Cesarean Section ; Enterocolitis ; Female ; Humans ; Infant ; Liver ; Portal Vein* ; Pregnancy ; Radiography ; Ultrasonography ; Ultrasonography, Doppler

The indication of CT for the breast lesions are 1) Unusually extensive or small breast caused technicaldifficulties in performing mammograms. 2) Questionable mammographic findings, especially in dense proliferativebreast parenchyme, 3) Microcancer. 4) Suspicious regional lymph node enlargement of invasion of the chest wall bybreast cancer. The diagnosis of breast CT in breast cancer is based on pathologic anatomic change andcharacteristic increase of mean CT No. of lesion following contrast enhancement. Authors analysed CT of the 34patients who were clinically suspected breast cancer, and compared with mammography. The results are as follows:1. Pathological diagnosis of 34 cases were 27 cases of breast cancer, 4 cases of fibrocystic disease, 2 cases offibroadenoma, and 1 case of intraductal pupilloma. The diagnostic accuracy of CT in 27 breast cancer was 93%(25cases) and mammography 71%(19 cases). 2. Corect diagnosis of CT in 7 benign breast disease is in 5 cases andmammography in 5 cases. 3. The most importment finding of CT in breast cancer is characteristic increase of CT No.of lesion following contrast enhancement (200ml, 65%): over average 50HU in 19 cases of 27 breast cancers, 30-50HUin a 6 cases, 20-30HU in 2 cases with tumor necrosis. 4. Compared with mammography, other more valuable CTfindings of breast cancer are axillary lymph node enlargement and adjacentic pectoral muscle invasion. 5. Inconclusion, Breast CT is considered as a valuable diagnostic tool in evaluation of breast cancer, but not of benign breast disease.
Breast Diseases ; Breast Neoplasms ; Breast ; Diagnosis ; Lymph Nodes ; Mammography ; Necrosis ; Thoracic Wall

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

The Marfan's syndrome is a collagenous hereditary disorder affected by the long bone, heart and eyes. Two cases of Marfan's syndrome are presented. Both two cases showed upward dislocation of lenses. We performed extraction of lenses on 4 eyes among the two cases by means of Cryo-extractor. The results of surgical treatment are described.
Collagen ; Dislocations ; Heart ; Marfan Syndrome*

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.
Activities of Daily Living ; Apgar Score ; Daejeon ; Humans ; Inpatients* ; Jeollabuk-do ; Rehabilitation* ; Solar System

To evaluate the normal range of articular disk postion, MRIs of 25 temporomandibular joints(TMJs) in 19 asymptomatic volunteers were analysed. On the closed mouth sagittal T1 weighted MRI the junction of the posterior band and bilaminar zone was within 10°anterior from the vertical line through the apex of condylar head in 19 (76%) lad within 20°in 23 (92%) TMJs. The intermediate zone of the articular disk was located between the posterior surface of articular eminence and the anterior surface of condylar head in 22 (88%) TMJs. We suggest that on the closed mouth sagittal MRI the junction of the posterior band and the bilaminar zone could be within 10°anterior from the vertical line through the apex of condylar head in asymptomatic Korean persons. If the junction is located more than 20°anterior from the vertical line or the intermediate zone is anterior to the anterior surface of condylar head it is suggested that the disk is anteriorly displaced. Further studies are needed to evaluate the clinical significance of mild anterior displacement of the articular disk(11°-20°) in asymptomatic persons.
Head ; Humans ; Magnetic Resonance Imaging* ; Mouth ; Reference Values ; Temporomandibular Joint* ; Volunteers

We investigated fifteen men and twenty one women, who were diagnosed to have asteroid hyalosis between June, 1997 and November, 1997 at Seoul National University Hospital. After obtaining their medical history a complete eye examination was performed. Specimen was examined by light microscope in one case. Funduscopic examination revealed bilateral involvement in 5 cases. Twenty six patients were diabetic and 12 were hypertensive. There was a significant association with diabetes. Light microscopic exam showed variable sized spherical structures with brown rim. Further decrease in visual acuity due to asteroid hyalosis was not observed in 35 cases in which follow-up exams were possible. In conclusion, asteroid hyalosis rarely caused visual loss and were likely to be monocular and to occur in old age.
Female ; Follow-Up Studies ; Humans ; Male ; Seoul ; Visual Acuity