BACKGROUND: This study was performed to determine and compare the practice patterns of management of hypertension of the internists and family physicians in general hospitals and to compare them according to the JNC V guidelines. METHODS: Questionnaires were mailed to total 964 of internists and family physicians in general hospitals during May, 1996. 217 of them were returned with the response rate of 23.5%. Chi-square test and Fishers exact test were performed to examine the statistical difference between two groups. RESULTS: The mean age of the respondents was 39.1 and 77.9% of them were male. 65.4 % of hospitals for respondents were located in metropolitan cities. Concerning the number of measurements of blood pressure, 0.5% of the respondents measured just once before confirmation of the diagnosis. Items for physical examinations for initial evaluation were as follows; cardiac auscultation(94.0%), measurements of body weight and height(58.9%), abdominal examination(52.8%), auscultation for carotid bruit(41.7%), fundoscopic examination (25.6%). Regarding the laboratory tests, the frequency of evaluation of all item were higher than that of the physical examinations. For initial drug therapy, calcium channel blockers and ACE inhibitors were the most frequently chosen mediations. No difference was found between two specialties or tertiary and secondary hospitals in this trend. With educations for the life-style modification, 60-80% of the respondents educated the patients. No difference was found between two specialties except one item. CONCLUSIONS: As a whole the JNC V guidelines were not followed faithfully for the management of hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Auscultation ; Blood Pressure ; Body Weight ; Calcium Channel Blockers ; Surveys and Questionnaires ; Diagnosis ; Drug Therapy ; Hospitals, General* ; Humans ; Hypertension* ; Male ; Physical Examination ; Physicians, Family* ; Postal Service ; Surveys and Questionnaires

Osteoporosis causes a decrease in bone mineral density. To overcome the decrease in fixation strength, a variety of techniques and devices have been developed, including cement augmentation of pedicle screws. Polymethyl methacrylate (PMMA), is commonly known as bone cement, and is widely used for implant fixation in various orthopaedic and spine surgery. In general, PMMA augmentation of pedicle screws is simple and safe if performed with technical precautions. PMMA is a safe agent, but it may rarely lead to significant foreign body reactions. In this report, we present a patient who developed bone cement-related epidural space foreign body granuloma
Osteoporosis

It is common to find a nose with a hump, lower nasal tip and a radix among Koreans. A common procedure as an aesthetical improvement for such feature, involves rasping of the hump, while lifting the tip and the bridge at the same time. As for the hump, en bloc resection is a well-known, traditional surgical method, but it may cause an open roof deformity, which leads to a high possibility of infection if dorsal augmentation using silicone was performed through it as it connects the nasal cavity and dorsum. To overcome this complication, the hump on the bony portion and cartilaginous has been improved by a modified autospreader graft. Also, the graft can also be used for tip-plasty in dorsal augmentation using silicone, septal extension graft, strut and onlay graft. As a result of constant monitoring for a year, the reformation of the hump and infection was not found.
Congenital Abnormalities ; Inlays ; Lifting ; Methods ; Nasal Cavity ; Nose ; Rhinoplasty ; Silicon ; Silicones ; Transplants*

BACKGROUND: The infection rate of intestinal parasites has been abruptly decreased during a couple of decades, but the report that Clonorchis sinensis has been decreased in infection rate was not shown. Because Clonorchis sinensis could induce the serious complications such as cholecystitis, cholelithiasis, cholangiocarcinoma, authors thought that clonorchiasis requird early diagnosis, treatment and prevention. Therefore the authors surveyed the infection pattern of Clonorchis sinensis for inhabitants who lived in Miryang city, well-known as endemic area for a long time, located at lower basin of Nakdong river. METHODS: The 661 subjects that received workers health examination in Miryang Youngnam General Hospital from September to November, 1996, were surveyed by using questionnaire, skin test and stool egg examination. This questionnaire contained history, duration, frequency of raw freshwater fish ingestion, history and treatment of clonorchiasis, history of other hepatic disease. The authors performed laboratory examination to 54 stool egg positive subjects. RESULTS: Among 661 subjects, the stool egg positive subjects were 54 and showed 8.2% in infection rate. In male(8.9%), stool egg positive rate was higher than female(4.9%). As age increased, stool egg positive rate also increased. Compared to the age group less than 30, stool egg positive rate was higher among age group 30 or over, particularly, in age group 50 or over, stool egg positive rate showed highest infection rate, 31.6%. And stool egg positive rate was increased according to increase of period, frequency of raw freshwater fish ingestion. Subjects with history of clonorchiasis and administrating Praziquantel had higher infection rate than the other subjects without the history. CONCLUSIONS: In this survey, the authors thought that high risk factors of clonorchiasis were male, age of 30 or over(particularly age of 50 or over), more than 10 years in raw freshwater fish ingestion period, more than twice per month in raw freshwater fish ingestion frequency. Then people having these risk factors must be performed various examinations for clonorchiasis, although they had not clinical symptoms, signs and abnormal laboratory findings.
Cholangiocarcinoma ; Cholecystitis ; Cholelithiasis ; Clonorchiasis ; Clonorchis sinensis* ; Early Diagnosis ; Eating ; Fresh Water ; Gyeongsangnam-do ; Hospitals, General ; Humans ; Male ; Ovum ; Parasites ; Praziquantel ; Risk Factors ; Rivers* ; Skin Tests ; Surveys and Questionnaires

BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.
Antibodies, Antinuclear ; Autoantibodies ; Female ; Follow-Up Studies ; Heart Block ; Humans ; Infant ; Lupus Erythematosus, Cutaneous

Acupuncture with gold needle insertion is utilized in Oriental medicine, and the effect of therapy is represented by anti-inflammatory and analgesic function, But sometimes the needle is erroneously inserted into abdominal organs, and then it may cause dangerous complications. We report a case of multiple gold needles in the abdominal organs without having definete clinical symptoms.
Acupuncture* ; Medicine, East Asian Traditional ; Needles* ; Radiography*

BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.
Adult ; Age Distribution ; Alcohol Drinking ; Chungcheongnam-do ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Hypertriglyceridemia ; Life Style ; Liver Function Tests ; Male ; Middle Aged ; Obesity ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

Nowadays shoulder ultrasound is commonly used in the assessment of shoulder diseases and is as accurate as magnetic resonance imaging in the detection of several pathologies. Operator dependence is the main disadvantage of shoulder ultrasound. After adhering to a strict examination protocol, good knowledge of normal anatomy and pathologic processes and an awareness of common pitfalls, it can be used as a focused examination providing rapid, real-time diagnosis, and treatment by ultrasound-guided interventions in desired clinical situations. Also shoulder ultrasound can help the surgeon decide whether treatment will be surgical or nonsurgical. If arthroscopy is planned, sonographic findings help to counsel patients regarding surgical and functional outcomes. If a nonsurgical approach is indicated, ultrasound can be used to follow patients. This review article presents the examination techniques, the normal sonographic appearances and the main pathologic conditions found in shoulder ultrasound. And also addresses a simplified approach to scanning and ultrasound-guided intervention. Knowledge of optimal techniques, normal anatomy, dynamic maneuvers, and pathologic conditions is essential for optimal performance and interpretation of images.
Arthroscopy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Pathologic Processes ; Pathology ; Shoulder* ; Ultrasonography*

No abstract available.
Insulinoma*