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

To assess the proportion of spectacles-wearing and an aspect of familial aggregation of myoptic spectacles-wearing and to observe the birth cohort for myoptic spectacles-wearing, a nationwide self-administered questionnaire survey was conducted from March 11 to September 19, 1985. A probability sample of 13,346 persons was taken from 180 enumerated districts designated by the fifth nationwide tuberculosis prevalence survey from Korean Institute of Tuberculosis. The major findings of this survey are as follows: 1) Total of 62.5% of the study population lived in urban area whereas 37.5% lived in Eup-Myun area. There was statistically significant difference in age and sex distribution between two residential area. 2) The percentage of spectacles-wearing was 8.3% and among these, myoptic and hyperoptic spectacles were 6.0%, 2.3%, respectively. A total of 8.8% of the male study population wore spectacles and this was slightly higher than the female (8.0%). 3) Among the occupational groups, students were the highest myoptic spectacles-wearing group whereas professionals were the highest hyperoptic spectacles-wearing group. 4) The proportion of myoptic spectacles-wearing was higher in female students than in male students respectively 11.6%, 8.7%. There was an increasing tendency of spectacles-wearing as age increased. 5) The age-sex adjusted prevalence rate of myoptic spectacles-wearing by residential areas was 2 times higher in urban area than Eup-Myun area. 6) A wearing of the myoptic spectacles in early age was observed in recent birth cohort than remote birth cohort. 7) There was a tendency of familial aggregation for myoptic spectacles-wearing. The proportion of myoptic spectacles-wearing was 6 times higher for those who had parents wearing spectacles. 8) 60.9% of the total myoptic spectacles-wearing persons received the eye-specialist's order and 44.9% for the hyperoptic spectacles wearing.
Cohort Studies ; Eyeglasses ; Female ; Humans ; Korea* ; Male ; Occupational Groups ; Parents ; Parturition ; Prevalence ; Surveys and Questionnaires ; Sampling Studies ; Sex Distribution ; Tuberculosis

Porokeratosis is an uncommon autosomally dominant inher ted disorder. Clinically, it is characterized by nonhealing plaques that develop most comnorly on the limbs. We report a case of disseminated superficial porokeratosis in immunosuppre sed kidney transplant recipient. An abrupt and extensive eruption of porokeratosis was observed in a 46-year-old man 7 months after renal transplantation, while being treated with cyclosporin A and prednisone. The histological features were essentially the same as the typical cornoid lamella. Immunosuppression may exacerbate or initiate the developm nt of porokeratosis in patients predisposed to alterations of cutaneous growth dynamics.
Cyclosporine ; Extremities ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Middle Aged ; Porokeratosis* ; Prednisone ; Transplantation*

A 77-year old man living in Kyunggi-Do, Korea was surgically treated at Seoul National University Hospital on April 1981, because of acute abdomen. At laparotomy, a 1.77m long adult Taenia saginata was found both in gallbladder and in common bile duct to cause acute gangrenous cholecystitis. The relevant literature were reviewed and possible mechanisms of the disease were discussed.
parasitology-helminth-cestoda ; Taenia saginata-taeniasis ; case report ; gallbladder ; common bile duct ; acute abdomen ; laparatomy

STUDY DESIGN: This study assessed the final functional results after treatment of thoracolumbar burst fractures and compared the relationship between the results and the parameters of reduction and state of the fractures. OBJECTIVES: To define prognostic factors affecting the final results and to present some precautions to minimize the treatment failure. SUMMARY OF LITERATURE REVIEW: In the treatment of the thoracolumbar burst fractures in which flexion loads are predominant, the sagittal contour is crucial to achieve permanent pain-free stability, but definitive therapeutic guidelines have remained a controversal topic. MATERIALS AND METHODS: We reviewed 37 thoracolumbar burst fractures with an average follow up period of 1.8 years: group 1 consisting of 20 cases treated conservatively and group 2 consisting of 17 cases treated surgically with posterior instrumentation. Finally functional results were analysed with the Denis'pain and work scores, and were compared between groups on anterior body height and local kyphosis. RESULTS: A satisfactory pain score less than or equal to P3 was in 15(75%) in group 1 and 15(88.2%) in group 2(p>0.05), but satisfactory work score less than or equal to W3 was in 12(60%) in group 1 and in 14(82.4%) in group 2(p<0.05). But, some loss of body height and local kyphosis in group 1 was not reversely related with functional outcomes. Eight cases in group 1 showing unsatisfactory result in work scores were analyzed as 4 osteoporosis(Jikei grade I, II/III), 3 associated compression fracture of the contiguous vertebra and one combined osteoporosis and compression fracture, showing significant loss of vertebral height and increase of kyphosis(p<0.01). CONCLUSIONS: Functional results of group 1 showing loss of vertebral height less than 50% and increased kyphosis less than 200 were comparable to those of group 2. The osteoporosis and associated compression fracture of adjacent vertebra were the risk group to develop posttraumatic kyphosis and might be added to the surgical indication of the thoracolumbar burst fractures.
Body Height ; Follow-Up Studies ; Fractures, Compression ; Kyphosis ; Osteoporosis ; Spine ; Treatment Failure

Open tibial pilon fractures present extensive soft tissue disruption and common complications such as sepsis or skin slough, and deserve special cosideration in addition to the challenging reconstructive problems. The purpose of this study is to assess the effectiveness of limited internal fixation and external fixation for the treatment of the open tibial pilon fractures, and to introduce some idea in Ilizarov device use. We reviewed 27 open tibial pilon fractures treated with limited internal fixation and external fixation from Feb. 1992 to Mar. 1996(follow-up range, 1 to 5 years). Fracture classification(Ruedi and Allgower) was type I in 5, type II in 10 and type III in 12, open wound type(Gustilo-Anderson) was II in 8, IIIA in 17 and IIIB in two. Secondary procedures were 16 soft tissue procedures, 13 bone graftings and 2 limb lengthening. Mean time for removal of the external fixators was 3.5 months(range, 6 to 21 weeks), and clinical union averaged 4.3 months(range, 12 to 25 weeks). At the time of last follow-up, radiologic grading(Burwell and Charnley) showed 13 good(48%), 10 fair(37%) and 4 poor results(15%). Objective functional grading(Ovadia and Beals) showed 5 excellent(19%), 15 good(56%), 6 fair(22%) and 1 poor(4%), and subjective grading 2 excellent(7%), 16 good(59%), 7 fair(26%) and 2 poor(7%). Common complications included 10 wound sepsis(37%), 6 posttraumatic arthritis(22%) and 5 malunions(19%). In conclusion, we cosider limited internal fixation and external fixation is an effective treatment modality till bone union for open tibial pilon fractures, and Ilizarov method using tension wires crossed only through the fracture fragments can provide a sufficient early and late stability.
External Fixators ; Extremities ; Follow-Up Studies ; Ilizarov Technique ; Sepsis ; Skin ; Tibia ; Transplants ; Wounds and Injuries

The increasing use of intravenous polyethylene catheters has led to a growing incidence of accidental catheter breakage and migration of fragments into the central vascular system usually in the inferior vena cave, the right atrium, of the pulmonary artery. The most common complications were formation of a thrombus in the area of the foreign body, infection with endocarditis, and perforation of the heart. And so obviously the polyethylene catheter must be removed. In 1967, Massumi and Ross et al have been successful in removing a catheter fragment from the right atrum percutaneously with a snare device. With some modification as suggested by Curry, method of retrieving fragments of polyethylene catheters from the heart without chest surgery utilize wire snares or endoscopic forceps. This report describe the technique and its use in successfully managing these complications in four consecutive cases.
Catheters* ; Endocarditis ; Foreign Bodies ; Heart Atria ; Heart* ; Incidence ; Polyethylene ; Pulmonary Artery ; SNARE Proteins ; Surgical Instruments ; Thorax ; Thrombosis

Spinal epidural hematoma is a rare complication of epidural anesthesia and most commonly associated with intraoperative or postoperative anticoagulant administration. We describe the case of an acute thoracolumbar epidural hematoma at the T12-L4 level complicated by cauda equina syndrome, which occurred after placement of spinal epidural catheter for anesthesia and anticoagulant therapy for acute myocardial infarction developed postoperatively. In our experience, the spinal epidural catheterization and anticoagulant therapy may potentially increase the risk of epidural hematoma formation.
Anesthesia ; Anesthesia, Epidural* ; Catheterization ; Catheters ; Cauda Equina* ; Hematoma* ; Hematoma, Epidural, Spinal ; Heparin* ; Myocardial Infarction ; Polyradiculopathy*

Familial polyposis is inherited as an autosomal dominant trait. It is characterized by the progressive development of hundreds to thousands of adenomsteus polyps in the large intestine. A patient who inherited the gene for familial polyposis is asually asymptomatic until after puberty, at which time polyps begin to appear. The disease at first non-malignant but after an interval of a few months or years, the development of colon cancer is inevitable. In Korea, several cases were reported, but almost all of the cases had incomplete familial histories. We experienced one case of familial polypasis in 33-year old Korean male who had no malignant changes in the adenomatous polyps. Among his family, his father and his brother have adenomatous polps in the colon and the rectum confirmed through total colonoscopy with biopsy. We report a case of familial polyposis of colon with a brief review of literatures.
Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Adolescent ; Adult ; Biopsy ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Fathers ; Humans ; Intestine, Large ; Korea ; Male ; Polyps ; Puberty ; Rectum ; Siblings

BACKGROUND: Recently, serologic techniques for tuberculosis have been developed and some of them, which are focusing on detection of serum antibodies mainly directed against specific 38-kDa Mycobacterium tuberculosis, have already been introduced into the market. In this study, diagnostic significance of a new serologic test(ELISA kit) for pulmonary tuberculosis was evaluated. METHODS: Serologic test with newly developed ELISA kit was performed upon 474 individuals, who include 333 active pulmonary tuberculosis patients, 80 healthy cases, and 61 tuberculosis contact cases. This serologic test was based on the ELISA technique and designed to detect antibodies to mixed complex antigens including 38-kDa, which were developed by Erume Biotech Co.,Seoul.Active pulmonary tuberculosis was diagnosed by sputum AFB smear and culture methods. RESULTS: The seropositivities using this ELISA kit were 82.1% and 73.6% in smear-positive and negative groups among active pulmonary tuberculosis, respectively. And, it also showed that seronegativities were 97.5% and 85.2% in healthy and contact groups, respectively. As a whole, the results of our study suing the ELISA kit as a diagnostic methiod for pulmonary tuberculosis showed 80.0% sensitivity for active pulmonary tuberculosis, 97.5% specificity, 96.1% positive predictive value, and 65.0% negative predictive value when the prevalence of tuberculosis in the samples was 60.1%. CONCLUSION: Our results reveal that the detection of antibody its reaction with 38-kDa antigen of M.tuberculosis is not sufficient to be accepted as single diagnostic method for pulmonary tuberculosis. However, they suggest that ELISA kit may be considered as an adjunctive test to standard diagnostic techniques of pulmonary tuberculosis.
Antibodies ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Prevalence ; Sensitivity and Specificity ; Serologic Tests* ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*