To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over 610,000 won, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (P<0.05). Parents noticed the child's abnormality first in 85.1% of the case whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.
Acupuncture ; Busan ; Cerebral Palsy* ; Child Development ; Child* ; Daegu ; Diagnosis ; Disabled Persons ; Education ; Fathers ; Humans ; Male ; Mothers ; Parents ; Rehabilitation Centers ; Schools, Medical ; Specialization

Controversy persists regarding the abnormality of the bone metabolism in various bone diseases. Osteocalcin, the vitamin K-dependent protein synthesized in bone, has been shown to be a specific and sensitive marker of bone turnover in metabolic bone diseases. The author measured the serum osteocalcin level using newly developed radioimmunoassay (RIA) in the patients with osteogenesis imperfecta, metastatic bone tumor, postmenopausal osteoporosis and rheumatoid arthritis, which can be the causes of osteoporosis, and ankylosing spondylitis. The aim of this paper is to demonstrate the value of the osteocalcin measurement comparing the each data of disease group with the normal control group. The results were as followings ; 1. The mean of osteocalcin in normal Korean was 4.43±1.04 ng/ml. (4.45±1.08 ng/ml in male, 4.41±1.01 ng/ml in female). The difference between male and female was not significant statistically. 2. The osteocalcin of osteogenesis imperfects was 9.14±2.21 ng/ml, which was significant statistically, And it was thought to be the result of increasing bone turnover rate and the osteocalcin was useful as biochemical marker. 3. In metastatic bone tumor, osteocalcin was under the normal level in both untreated and treated groups, which meant low bone turnover rate or low osteoblastic activity. Osteocalcin was not a useful marker for the assessment of the effect of treatment in this study, but if the radioimmunoassay was done in the same tumor group, a valuable results could be expected. 4. Osteocalcin level in the patients with postmenopausal osteoporosis and rheumatoid arthritis was not different with normal control group and osteocalcin was not useful marker for the evaluation of the degree of osteoporosis and bone turnover. 5. Osteocalcin didn't play a role in the pathologic ossification of ankylosing spondylitis. In conclusion, the osteocalcin by radioimmunoassay can be used as a biochemical marker in metabolic bone diseases and metastatic cancer for the disgnosis and the assessment of prognosis or the effect of treatment.
Arthritis, Rheumatoid ; Biomarkers ; Bone Diseases ; Bone Diseases, Metabolic ; Bone Remodeling ; Female ; Humans ; Male ; Metabolism ; Ossification, Heterotopic ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteogenesis Imperfecta ; Osteoporosis ; Osteoporosis, Postmenopausal ; Prognosis ; Radioimmunoassay ; Spondylitis, Ankylosing ; Vitamins

Ganglion is a common clinical entity, usually superficial in location, therefore easily diagnosed and most common tumors of the hand which represent 50 to 70% of all soft tissue tumors of the hand. The soft mucin filled cyst is attached to the adjacent underlying joint capsule, tendon, or tendon sheath. The most common ganglion is the ganglion on the dorsal side of wrist, with its origin at the scapulolunate ligament and is usually located between the extensor digitorum communis of the index finger and the extensor pollicis longus tendons. Intratendinous ganglion is very rare lesion that originates within the tendon, which has been reported 10 cases in earliest articles and 1 case in Korean article. We report one case of ganglion that arose within the extensor digitorum communis of the middle finger.
Fingers ; Ganglion Cysts ; Hand ; Joint Capsule ; Ligaments ; Mucins ; Tendons ; Wrist

No abstract available.
Immunoglobulins* ; Lactoglobulins* ; Milk*

Wiskott-Aldrich Syndrome is an X-linked disorder characterized by recurrent infection, thrombocypenia and eczema. Various defects in cell-mediated immunity and deficient antibody reponse to carbohydrate antigens have been described. We experienced a case of Wiskott-Aldrich Syndrome of 28 months old male patient. He has been suffered from multiple petechiae with bleeding, recurrent pyogenic infections and generalized eczema since 3 months of age. Immunological abnormalities are as follows: 1) Serum IgM was gradually decreased, while IgA and IgE were increased. 2) Antibody response against polysaccharide antigen (PRP) was not observed after 3 times of PRPT immunization. 3) CD4/CD8 ratio was reversed (0.6). 4) Proliferative response of mononuclear cells was significantly reduced, and CMI skin test also showed negative results. A brief review of literature was made.
Antibody Formation ; Child, Preschool ; Eczema ; Hemorrhage ; Humans ; Immunity, Cellular ; Immunization ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin M ; Male ; Purpura ; Skin Tests ; Wiskott-Aldrich Syndrome*

No abstract available.
Immunoglobulin G* ; Influenza, Human*

No abstract available.

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1--30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (+/-58.6) minutes; 2023(+/-50.7) minutes for the university hospitals and 164.2(+/-60.5) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the major reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430Won. Out of the total medical fee, 20,323Won(9.3%) was for the newborn nursery care. In case of C-section delivery six nights and seven days, who stayed otal medical fee was 732,578Won and out of the total fee 76,937Won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141Won for the tertiary care hospitals and 14,576Won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.
Education ; Fee Schedules ; Fees and Charges ; Fees, Medical* ; Hospitals, General ; Hospitals, University ; Humans ; Infant, Newborn* ; Insurance ; Investments ; Maintenance and Engineering, Hospital ; Nurseries* ; Nursing ; Nursing Care ; Nursing, Supervisory ; Pediatrics ; Salaries and Fringe Benefits ; Tertiary Healthcare

No abstract available.
Ambulances* ; Cardiopulmonary Resuscitation*

One of the primary functions for which bones have evolved is to act as a structural support. To achieve this, bones remodel throughout life so that their structure remains optimal for the prevailing mechanical environment. Bone remodeling consists of an initial phase of osteoclastic bone resorption followed by a bone formation period. Prostaglandins are potent regulators of bone formation and bone resorption that can have both stimulatory and inhibitory effects. Elevation of intracellular cAMP is an important intracellular signaling mechanism involved in the regulation of the expression of many proteins. In this study we examine whether PGE or DBcAMP affects osteoblastic activation or osteoclastic differentiation in mouse bone marrow cells and osteosarcoma ROS 17/2.8 cells. The effect of PGE and DBcAMP on the cell proliferation was measured by the incorporation of [3H]- thymidine into DNA. As a result, PGE2 (0.5-1 ug/ml) and DBcAMP (0.1-0.5 mM) inhibited the [3H]-thymidine incorporation into DNA in a dose dependent manner. The effect of PGE2 and DBcAMP on the induction of alkaline phosphatase (ALP) was investigated in ROS 17/2.8 cells cultured in medium containing 0.4% fetal bovine serum. PGE and DBcAMP stimulated ALP activity in the cells in a dose- dependent manner. PGE2 also increased the intracellular cAMP content in a dose- dependent fashion with a maximal effect at 0.5 ug/ml. ROS 17/2.8 cells release nitric oxide upon stimulation of PGE2 or DBcAMP with interferon-r. PGE2 and DBcAMP increase the phosphorylation level of CREB (cAMP response element binding protein) without any change on the amount of CREB protein. Also, PGE (10-6 M) and DBcAMP (10-4 M) significantly increase the generation of osteoclasts in mouse bone marrow cell culture system. In conclusion, the results of this study suggested that cAMP appears to be an important regulatory molecule in the processes of bone formation and resorption.
Alkaline Phosphatase ; Animals ; Bone Marrow Cells ; Bone Remodeling ; Bone Resorption ; Bucladesine* ; Cell Proliferation ; Cyclic AMP Response Element-Binding Protein ; Dinoprostone* ; DNA ; Metabolism* ; Mice ; Nitric Oxide ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Osteosarcoma ; Phosphorylation ; Prostaglandins ; Prostaglandins E ; Response Elements ; Thymidine