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

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*

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

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

Until recently, the cervical pregnancy have been treated with surgery, usually hy- sterectomy, because of uncontrollable heavy vaginal bleeding. The development of sophisticated ultrasound which allows early diagnosis of cervical pregnancy and methotrexate chemotherapy opened up new therapeutic options in the management of this unusual but potentially life threatening complication of pregnancy which have been always a nightrnare for the gynecologist. We are reporting a case of cervical pregnancy diagnosed in 12 weeks of gestation. The patient was successfully treated with alternative administration of methotrexate (1 mg/kg, intramuscularly) and leucovorin (0.1 mg/kg, intramuscularly) without surgical intervention, in order to preserve both the uterus and fertility. Follow up was done with serum beta hCG and pelvic ultrasonography. Complete resolution of the cervical pregnancy was obtained at 50 days after starting methotrexate treatment. This case gave us the opportunity to review the recent literature on cervical pregnancy.
Drug Therapy ; Early Diagnosis ; Fertility ; Follow-Up Studies ; Humans ; Leucovorin* ; Methotrexate* ; Pregnancy* ; Ultrasonography ; Uterine Hemorrhage ; Uterus

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*

To compare between the Worth 4-dot test(W4D) with polarized 4-dot test(P4D), we examined the interpretable response rate, response time, age of test failure, false positive rate and negative rate of reporting fusion in 133 patients older than 3 years of age. The interpretable response rate for W4D was 91% and for P4D 93.2%. The mean response times were 20.9 seconds for W4D versus 16.9 seconds for the P4D, the difference being statistically significant(p<0.05). The age of test failure for W4D was 4.8 years old and for P4D 3.8 years old. The false positive rate of reporting fusion for W4D was 4.5% and for P4D 8.8%. The false negative rate for W4D was 37.5%, while for P4D was 15.2%, the difference being statistically significant(p<0.05). In conclusion, the P4D was found to be less dissociative test by allowing more natural environment, and was easier, more rapid interpretable test. Therefore, the P4D may provide a more accurate assessment of a patients sensory status.
Humans ; Reaction Time

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*

In order to compare the corneal sensation after phacoemulsification and the planned extracapsular cataract extraction(p-ECCE), we studied 40 eyes of 31 patients prospetively. A Cochet-Bonnet esthesiometer was used to measure corneal sensitivity preoperatively and at one day, three day, one week, one month, and two months postoperatively, by the same surgeon using the same technique. There was no difference in corneal sensation between phacoemulsification and p-ECCE group preoperatively. The mean corneal sensitivity at 10:00(2:00) o`clock in phacoemulsificantion/p-ECCE was 17.3+/-7.0(18.2+/-6.7)/9.9+/-1.5(10.3+1.9), 22.1+/-6.9 (23.2+/-6.3)/14.1+/-2.3(14.3+/-2.3), 29.4+/-7.7(30.6+/-7.2)/17.7+2.2(18.7+/-2.2), 37.7+/-9.3(37.8+/-9.4)/26.3+/-7.9(27.7+/-8.4), 56.3+/-7.6(56.3+7.9)/59.2+/-3.8(59.4+/-2.7)mm after 1, 3, 7, 30, 60 days, respectively. Corneal sensation at the center and the 3, 6, and 9 o`clock positions was not changed in all eyes. Corenal sensitivity was significantly more recovered in phacoemulsification group than the p-ECCE group at postoperative onemonth(p<0.05). However, there were no statistically significant difference in recovery of corneal sensation between phacoemulsification group and p-ECCE group at postoperative two months. Conclusively corneal sensation returned to peroperative level at two months postoperatively in both groups.
Cataract Extraction* ; Cataract* ; Humans ; Phacoemulsification* ; Sensation*