No abstract available.
Echocardiography*

No abstract available.
Child* ; Cranial Irradiation* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

BACKGROUND: Family physicians should actively carry out adult immunization. DM is a common risk factor of influenza and pneumococcal pneumonia related complications, so DM patients should receive influenza and pneumococcal vaccinations. The authors investigated recognition and performance of influenza and pneumococcal vaccination among DM patients. METHODS: We surveyed knowledge and performance of influenza and pneumococcal vaccination among the 203 diabetic patients living in Seoul and responding to telephone interview, who visited one DM center in general hospital from March 3, to March 7, 1997. RESULTS: Among 203 DM patients, the risk factors for influenza and pneumococcal pneumonia other than DM were old age of 65 or over(35.0%), cardiovascular diseases(5.9%) and chronic pulmonary diseases(4.9%). The recognition rate and performance rate of influenza vaccination were 27.6% and 21.2% respectively, there was a statistically significant relationship between these rates(P<0.01). Those vaccinated 43 patients for influenza knew the need of vaccination through family members and relatives(58.1%) and through medical doctors(32.6%). Although 85.2% of 203 DM patients answered that they received education about need of vaccination through DM education program conducted at hospitals, but only 9 patients(4.4%) recognized well. The reasons for not performing influenza vaccination were lack of knowledge(63.1%), no experience of influenza(12.5%), 'forget for the moment(5.0%) and regard injection as a nuisance(2.5%) in descending order. The recognition rate and performance rate of of pneurnococcal vaccination were all zero percents. The reasons for not performing pneumococcal vaccination were lack of knowledge(91.1%) no experience of pneumococcal pneumonia(6.4%), regard injection as a nuisance(1.5%) and forget for the moment(1.0%) in descending order. CONCLUSIONS: The recognition and performance rates of influenza vaccination were low and those of pneumococcal vaccination were all zero percents among DM patients because they did not recognize well the need of these vaccinations. Therefore, the doctors who see DM patients should actively recommend influenza and pneumococcal vaccination and DM educational programs must include education for these vaccinations.
Adult ; Education ; Hospitals, General ; Humans ; Immunization ; Influenza, Human* ; Interviews as Topic ; Physicians, Family ; Pneumonia, Pneumococcal ; Risk Factors ; Seoul ; Vaccination*

To estimate the cancer mortality rates among Koreans, a mortality survey was carried out in the province of Kyongsangnam-do. The study population are the beneficiaries of Korea Medical Insurance Corporation (KMIC), Kydngsangnam-do area, among which the 3,867 deaths occurred from January, 1989 to December, 1990, were reviewed to confirm the cancer deaths. These were based upon the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey was conducted along three steps. At first, the death certificates were examined, as a second step medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 990 deaths were found due to cancer. Using them, age and sex specific cancer(all sites and several sites) mortality rates were estimated. Overall cancer mortality rate in the area was estimated 138.7 per 100,000 person-years in males, and 65.7 in females, respectively. And the orders of site-specific cancer mortality rates were the cancers of stomach, liver, lung, esophagus, and cancers of the hematopoietic system among males, In females, followed by gastric cancer, cancers of lung and liver are the 2nd and 3rd in rank, respectively and cancers of breast and uterine cervix are the 4th and the 5th in rank.
Breast ; Cervix Uteri ; Death Certificates ; Esophagus ; Female ; Gyeongsangnam-do* ; Hematopoietic System ; Humans ; Insurance ; Korea ; Liver ; Lung ; Male ; Mortality* ; Stomach ; Stomach Neoplasms

To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyeongpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring (29.4%) and summer (29.4%), and the lowest in fall (17.7%). The highest incidence rate of accident was observed in Friday (24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post (51.8%) and the next was clinic (38.8%). Mean duration of treatment was 9.8 days. The accident occurred in the room and kitchen (23.5%), in the yard and barn (23.5%), on the road (22.4%), and in the rice field and dry field (20.0%). The causes of accident were motor vehicle accident (20.0%), piercing or cutting (20.0%), collision or fighting (12.9%), and poisoning (11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injured part of body was extremity 55.3%.
Agriculture ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Motor Vehicles ; Poisoning ; Prospective Studies ; Wounds and Injuries

BACKGROUND : The proportion and absolute number of older patients admitted through the emergency department (ED) are increasing yearly. As people getting older, they are more likely to suffer from emergency situation of disease, disability, and trauma. Combining with the decrease in physiologic reserve, these added burdens make the elderly more vulnerable to any of the additional situations. Understanding the implications of these facts is crucial to one who is providing optimal triage and emergency care to elderly (aged 65 years or older) and adults (between 15year of age and 64 years of age). METHODS : We conducted an observational survey of emergency patients age 15 or older who admitted to emergency department of Asan Medical Center. A convenience sample of 3,481 were divided into 2 groups by 65 years of age, and final results (admission vs. discharge) after emergency care was compared. The admission rate according to between two groups. We calculated odds ratios of important outcomes by pooling data from individual trials using logistic regression analysis. RESULTS : Admission rate of elderly was higher than adults as 59.2% versus 36.4% (odds ratio=2.32) 95% CI=1.21~3.24). Although vital signs were within normal ranges, admission rate of elderly was significantly higher than adults as follows; normal range of systolic blood pressure (56.0% vs. 35.5%), normal range of respiration rate per minute (55.4% vs. 36.4%), alert status of mentality (34.2% vs. 54.7%). CONCLUSION : We could not define the severity of emergency patients only by using vital signs and/or clinical symptoms, especially to the elderly patients. Even though the vital signs of elderly patients. emergency physician should manage them carefully because of the high severity of clinical condition in elderly then we expected. Emergency Geriatric Assessment tools must be developed differently from general triage tools.
Adult ; Aged* ; Blood Pressure ; Chungcheongnam-do ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Geriatric Assessment ; Humans ; Logistic Models ; Odds Ratio ; Reference Values ; Respiratory Rate ; Triage ; Vital Signs

This study was performed to assess the recurrence rate and the factors related with the recurrence of leprosy and to use the data obtained from the present study for the basis for the prevention of leprosy, among those leprosy patients who were registered and managed by a Catholic Skin Clinic located in the Taegu metropolitan city between January of 1960 to October of 1999. We conducted the present study with 1,245 leprosy patients except 31 who were being treated for active leprosy. Using a structured record sheet, the data were collected using the chart of the patient, and the collected data were analyzed using SPSS program ver 9.0 and Fisher's exact test and chi-square-test was performed. Among 1,245 subjects, the sex distribution was 690 males (55.4%) and 555 females (44.6%). The age at the time of initial occurrence of leprosy was the most prevalent in patients' teen years with 528 patients(42.3%) followed by in their 20's with 366 patients (29.3%). The most prevalent type of leprosy at the initial occurrence of leprosy was type L with 730 patients(58.6%), and the condition of the bacteria at the time of initial occurrence of leprosy was negative in 509 patients(40.8%) and positive in 285 patients(22.9%). The overall recurrence rate was 13.2%. According to gender, males showed the recurrence rate of 15.7% and females 10.1%, showing a higher recurrence rate in males. The recurrence rate according to the type of leprosy was 31.6% of I type with the most prevalence. Among those patients who were initially diagnosed with mycobacterium leprae, 21.1% showed recurrence, and the recurrence rate was significantly higher than in negative mycobacterium leprae patients with 3.3%. The recurrence rate according to the age of initial occurrence of leprosy was the highest in those patients who developed leprosy in their teen years with 17.2%, followed by those who had leprosy in between 20-29 years with 13.4%. According to the administered medication, among those 152 patients who took DDS alone, showed 90.8% recurrence rate; among 1,009 patients took in DDS and switched to MDT, 2.5% showed recurrence; and among patients who were treated with MDT, only 1.2% showed recurrence with the lowest level of recurrence rate. With these results, in the case of DDS treatment cases, in male patients, the positive mycobacterium leprae patients at the time of initial occurrence of leprosy, the type of leprosy being I, and the age of the initial occurrence of leprosy being low; it is important to raise the compliance through education and follow-up. In the future, extensive and in-depth studies are needed to be done in the recurrence of leprosy to elucidate the factors of recurrence and the plans to prevent recurrence need to be established from the public health and policy areas.
Adolescent ; Bacteria ; Compliance ; Daegu ; Education ; Female ; Humans ; Leprosy* ; Male ; Mycobacterium leprae ; Prevalence ; Public Health ; Recurrence* ; Sex Distribution ; Skin

This study was performed to assess the recurrence rate and the factors related with the recurrence of leprosy and to use the data obtained from the present study for the basis for the prevention of leprosy, among those leprosy patients who were registered and managed by a Catholic Skin Clinic located in the Taegu metropolitan city between January of 1960 to October of 1999. We conducted the present study with 1,245 leprosy patients except 31 who were being treated for active leprosy. Using a structured record sheet, the data were collected using the chart of the patient, and the collected data were analyzed using SPSS program ver 9.0 and Fisher's exact test and chi-square-test was performed. Among 1,245 subjects, the sex distribution was 690 males (55.4%) and 555 females (44.6%). The age at the time of initial occurrence of leprosy was the most prevalent in patients' teen years with 528 patients(42.3%) followed by in their 20's with 366 patients (29.3%). The most prevalent type of leprosy at the initial occurrence of leprosy was type L with 730 patients(58.6%), and the condition of the bacteria at the time of initial occurrence of leprosy was negative in 509 patients(40.8%) and positive in 285 patients(22.9%). The overall recurrence rate was 13.2%. According to gender, males showed the recurrence rate of 15.7% and females 10.1%, showing a higher recurrence rate in males. The recurrence rate according to the type of leprosy was 31.6% of I type with the most prevalence. Among those patients who were initially diagnosed with mycobacterium leprae, 21.1% showed recurrence, and the recurrence rate was significantly higher than in negative mycobacterium leprae patients with 3.3%. The recurrence rate according to the age of initial occurrence of leprosy was the highest in those patients who developed leprosy in their teen years with 17.2%, followed by those who had leprosy in between 20-29 years with 13.4%. According to the administered medication, among those 152 patients who took DDS alone, showed 90.8% recurrence rate; among 1,009 patients took in DDS and switched to MDT, 2.5% showed recurrence; and among patients who were treated with MDT, only 1.2% showed recurrence with the lowest level of recurrence rate. With these results, in the case of DDS treatment cases, in male patients, the positive mycobacterium leprae patients at the time of initial occurrence of leprosy, the type of leprosy being I, and the age of the initial occurrence of leprosy being low; it is important to raise the compliance through education and follow-up. In the future, extensive and in-depth studies are needed to be done in the recurrence of leprosy to elucidate the factors of recurrence and the plans to prevent recurrence need to be established from the public health and policy areas.
Adolescent ; Bacteria ; Compliance ; Daegu ; Education ; Female ; Humans ; Leprosy* ; Male ; Mycobacterium leprae ; Prevalence ; Public Health ; Recurrence* ; Sex Distribution ; Skin

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

The differentiation between lung abscess and empyema can be difficult, but has important therapeuticconsequences. Thoracostomy tube drainage is essential therapy for an empyema, whereas prolonged antibiotic therapyand postural drainage often suffice for a lung abscess. Conventional radiographic findings are usually relied onto help make correct indfferentiation between empyema and lung abscess, but overlying lung disease or unfavorablelocation of lesion often results in ambiguous findings. Although ultrasound has proved useful in differentiatingempyema from lung abscess, CT is best accurate diagnostic method. Authors reviewed chest CT of 50 cases(41empyemas, 9 lung abscesses)which were diagnosed by suegery or clinical background during the period from May 1980to June 1985 at Dongsan Medical Center, Keimyung University. The results were as follows: 1) Age and sexdistribution a) Empyema: The incidence was most common in the 6th and 7th decades. Male to female ratio was 3:1.b) Lung abscess: The incidence was most common in the 5th, 6th and 7th decades. Male to female ratio was 2:1. 2)Wall characteristics(empyema 32 cases, lung abscess 9 cases): The 9 cases of 41 empyemas had not defined theirwalls. a) Empyema had at least a part of their wall that was thin (81%), uniform width(84%), and smooth on bothmargins (more than 96%). b) The wall of lung abscess was thick (89%), and irregular margins(100%). 3) Separationof uniformly thickened visceral pleura from parietal pleura("split pleura" sign) was seen only in 68% of allempyemas. 4) Adjacent lung compression was seen only in 88% of all empyemas. 5) Chest wall angle: In 78% of allempyemas had obtuse or mixed angles, wherease in 85% of all lung abscesses had acute angle. 6) Shape oflesion:Empyema had variant shapes from round to crescent, however all lung abscesses had round or ovoid shape. 7)Size of lesion: In 85% of all empyemas had medium(41%) or large (44%) size, but the lung abscess had onlysmall(33%) or medium (67%) size. 8) Air in lesion was seen in 41% empyemas and in 89% lung abscesses. 9) Adjacentlung consolidation showed in 34% empyemas and in all lung abscesses. 10) Free pleural fluid was seen in 12%empyemas and in 89% lung abscesses. 11)Septated lesions were seen in 32% empyemas and in 56% lung abscesses. 12)Multiple lesions were seen in 44% empyemas and in 55% lung abscesses. 13) Mediastinal shifting was seen in 49%enpyemas and in 44% lung abscesses, but which all lung abscesses were coexisted with empyemas. 14) Pleuralcalcification was seen only in 5 cases(12%) of all empyemas. 15) Location of leison: Most(93%) of empyemas werelocated in posterolateral portion of hemithorax, and most (78%) of lung abscesses involved in right lower lobe.
Clothing ; Drainage ; Drainage, Postural ; Empyema ; Female ; Humans ; Incidence ; Lung Abscess ; Lung Diseases ; Lung ; Male ; Methods ; Pleura ; Rabeprazole ; Thoracic Wall ; Thoracostomy ; Tomography, X-Ray Computed ; Ultrasonography