Out of 3288 patients admitted National Leprosy Center in Sorok-do, could be selected 120 patients confirmed to have one or more plantar ulcers, whose frequency and localization form the basis of this clinical observation. 1. Of 120 patients, 32 had ulcers bilaterally, so that total 196 ulcers in 152 feet were subjected to study. 2. Male patients were approximately three times more frequent than female. Age range showed that 76(63.3%) of 120 patients were in their six and seven decade, and only three cases were under the third Decade. 3. The base of first metatarsal was the site with highest incidence of ulcer (28.6%), and the bases of all metarsals occupied 57.7% of all ulcers. The medial plantar and the heel were low in incidence. 4, Transverse division of the plantar surface revealed that ulcers were located predominantly in the forefoot part (64.8%), showing gradual decrease in the midfoot (27%) and the hindfoot region (8.2%) 5. Longitudinal section of the plantar surface into three compartments showed almost even distribution of ulcers, though the central ray showed slightly lower incidence than those of the medial and lateral ray. 6. Dynamic pressure triangle was found to be the site of preference, in which 100 ulcers(59%) of all was observed. 7. Non-lepromatous patients showed the higher rate of occurrence, in that they occupied 21.3% of all the patients, while 30.8% of 120 ulcer-patients were non-lepromatous type. 8. Of total 196 ulcers, those with history of more than ten years were 117(59.7%), and 18 of them had the history of more than 30 years.
Female ; Foot ; Foot Ulcer ; Heel ; Humans ; Incidence ; Leprosy ; Male ; Metatarsal Bones ; Ulcer

We experience a 1 day old female patient with congenital esophageal atresia and tracheoeso-phageal fistula combined with a subglottic laryngeal stenosis which was 2 mm in diamete. At the time of surgery, an attempt was made to intubate, but it was impossible to pass a tube beyond the vocal cord which was mormal in size and shape. Thus a gastrostomy was performed only under mask with pure oxygen and local anesthesia. The child died one day later due to respiratory failure. Congenital subglottic laryngeal stenosis combined with esophageal atresia and tracheoeso-phageal fistula is very rare, but it is a very critical anomaly to anesthesia and resuscitation. Therefore, in the case of esophageal atresia and tracheoesophageal fistula with signs of respiratory obstruction, the possible presence of subglottic laryngeal stenosis should be considered and accurately assessed.
Anesthesia* ; Anesthesia, Local ; Child ; Esophageal Atresia* ; Female ; Fistula ; Gastrostomy ; Humans ; Laryngostenosis* ; Masks ; Oxygen ; Respiratory Insufficiency ; Resuscitation ; Tracheoesophageal Fistula* ; Vocal Cords

The present study was designed to measure the activity of purine nucleosiae phosphorylase(PNPase) in sera and lymphocytes af peripheral blood from patients with allergie contact dermstitis and drug eruption since PNPase activities are known to be decreased in cell-mediated immune deficieney diseases. The PNPase activities in sera and lymphocytes of normal subjects were (7.2 +1.05) * 105 unit/L of sera and (1.85+0.38) unit/102 lymphocytes, respectively. In allergic contact dermatitis, the PNPase activities in sera and lymphocytes of patients were (3.9+0.78) *105 unit/L of aera and (0.69+0.23) uoit/102 lymphocyteis, which were signifieantly lower than those of normal subjects. There were no differences in PNPase activities of sera and lymphocytes between drug eruption patients and normal subjects. From these results, it is suggested that the lowered PNPase aetivity in allergie contact dermatitis might be associated with abnormal lymphocytes differentiation or activation or some other unknown mechanism, since lowered PNPase activity in allergic contact dermatitis is in contrast to the generally accepted concept that enhanced status of CMI in ACD will lead to the increase in PWPase activity.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Drug Eruptions* ; Humans ; Lymphocytes* ; Purine-Nucleoside Phosphorylase*

No abstract available.
Choledochostomy*

Study of filariasis to determine important factors involved in its ecology was carried out on Che Ju Island for three consecutive years from 1968 to 1970 in seven villages, three coastal villages and four islets remote from the main island. One village which was located in mountainous area far from the coast was surveyed to serve as control area. About 90% of population inhabiting the study area had at least one blood smear during the three-year period; about one third had three blood smears, and a little over one third had two, and the rest only one examination. Animal and mosquito surveys were carried out at the same period. Followings are the results obtained: All human cases but several had microfilariae identical to the description of B. malayi. The several cases who had morphologically different microfilariae from that of B. malayi need further study for definite conclusion. Five persons randomly sampled from Mf positives and bled every two hours demonstrated nocturnal periodicity between 9 p.m. and 3 a.m. Human is considered to be only reservoir host for human filariasis in the area since animal survey and experimental exposure to the infective larvae of human filaria species showed failure to infect animals. Microfilaria rate, microfilaria density, prevalence of elephantiasis varied by area and age with correlation, which indicated cumulative process of the parasite by repeated exposure and development of host immunity to certain extent. Clinical manifestation of filariasis (symptom complex and elephantiasis ) taken from history and inspection was low in its prevalence with range of 0.9% 11.8% of total population. Only 5.2% of 517 Mf positives had the clinical manifestation. 24.8% of 109 persons with clinical manifestation had microfilaria; 42.9% with symptom complex only, 23.1% with both symptoms and elephantiasis, and none with elephantiasis only were microfilaria positive. Ae. togoi was the only species infected with the filaria. Mosquito infection rate by area showed positive correlation to the Mf rate and density of human population; where the Mf rate and density were high, the mosquito infection rate also high.
parasitology-helminth-nematoda ; ecology ; epidemiology ; Brugia malayi ; filariasis

We experienced 53-year-old male patient, who had an eczematous verrucous plaque measuring 6 x 4cm in diameter on the nasal bridge for 4 months. On physical examination, there was no abnormality except of palpable bean sized nodule on the left side of chin for 2 months. The overlying skin of the nodule is a quite normal appearance. The skin biopsy of the nodule showed the charact.eristic a.rrangement of the infiltrate in three zones. And the result of fungus culture of the thin tissue slice on Sabouraud media diagnosed fungal infection due to Sporotherix .schenkii. The treatment began with oral ketoconazole for 4 weeks, and the medication was interrupted for 2 weeks, because of no favorable effectiveness. On his revisit, a chain of painless nodules along lymphatics palpated on the right side of his f ace. We changed the therapy into saturated solution of potassium iodide(KI) with 0.25ml(5 drops) orally there times a day and was gradually increased administration of KI, And no side effects were noted. The patient was treated for a. total of 18 weeks, which included 6 weeks of treatment following clinical resolution.
Biopsy ; Chin ; Fungi ; Humans ; Ketoconazole ; Male ; Middle Aged ; Physical Examination ; Potassium ; Skin ; Sporotrichosis*

OBJECTIVES: To estimate the effects of an oral vitamin supplementation on cognitive function in the elderly, 254 elderly people(experiment group) who were received an oral vitamin supplement for one-year was compared with 292 elderly who were treated as the control group in Koje city during the study period(from February 1997 to March 1998). METHODS: The cognitive function was tested by mini-mental state examination Korea(MMSE-K). Multiple regression analysis was done to control other confounding variables such as gender, age, educational level, smoking, alcohol, a past 15-day medical history, satisfaction for living cost, family number, cognitive function of the baseline survey. RESULTS: In the baseline survey, the prevalence of cognitive impairment was 31%(mild impairment 12.5% and severe impairment 18.5%). There was a significant difference(0.76) in cognitive change in the elderly between two groups, 0.68 improved in the experiment group and 0.08 worsen in the control group(p<0.01). In multiple regression analysis, the significant variables were an oral vitamin supplementation, a past 15-day medical history, family number, cognitive function of baseline survey(p<0.05). The improvement of cognitive function was observed in those who do not have a past 15-day medical history, have a large family number, and have a low cognitive function of the baseline survey. CONCLUSIONS: It appears that an oral vitamin supplementation was effective in improving the cognitive function in the elderly and more effective in the cases with abnormal cognitive function.
Aged* ; Confounding Factors (Epidemiology) ; Surveys and Questionnaires ; Gyeongsangnam-do ; Humans ; Prevalence ; Smoke ; Smoking ; Vitamins*

Severe bronchospasm after injection of succinylcholine iodide intravenously occurred in a 28 year old female during emergency Cesarean section. This was confirmed by repeated administration of the succinylcholine iodide and its symptoms with several referances are reviewed.
Adult ; Bronchial Spasm* ; Cesarean Section ; Emergencies ; Female ; Humans ; Pregnancy ; Succinylcholine*

To compare the rate of uptake and elimination of volatile anesthetics, we administered 2% Halothane, 2% Enflurane and 2% Isoflurane respectively for one hour to 90 healthy adult patients through a semicolsed circuit with controlled ventilation to maintain normocapnea for determining the rates of uptake, and the volatile anesthetics and nitrous oxide were discontinued to determine the rates of elimination for 30 minutes. The expired(Fe=Fa) and inspired(F1) vapor concentrations of volatile anethetics were measured using an infrared analyser and F(A)/ F(1) ratios were used to determine rates of uptake, and F(A)/F(AO)(Where F(AO) is the last end-tidal concentration during uptake) ratios were used to determine rates of elimination. And to evaluate the effects of gas flow pattern on the rate of uptake and elimination, the patients were divided into three groups: Control group inhaled three volatile anesthetics respectively with 3 liter of oxygen per minute, study group 1 inhaled three volatile anesthetics respectively with 6 liter of oxygen per minute and study group 2 inhaled three volatile anesthet- ics respectively with 1 liter of oxygen and 2 liter of nitrous oxide. The results obtained were as follows: l) To compare the rate of uptake(F(A)/F(1)) of the anesthetics, the pulmonary uptake was most rapid with isoflurane followed by enflurane and halothane in accord with their respective solubilities in blood 2) With increased fresh gas flow, the rates of uptake of anesthetics more rapidly augmented, especially significantly in halothane and enflurane 3) With gas mixture of 70% N2O, the rate of uptake of anesthetics more rapidly augmented, especially significantly in isoflurane and enflurane 4) To compare the rate of elimination of anesthetics, isoflurane and enflurane eliminated more rapidly than halothane but there are no difference in that of isoflurane with enflurane in control group. But there are no difference significantly between that of halothane, enflurane and isoflurane in study group 1 and 2. 5) With increased gas flow rate, the rate of elimination decreased more rapidly in halothane, enflurane and isoflurane significantly. 6) By the elimination of anesthetics with N2O simultaneously from the lung, the rate of elimination decreased more rapidly in halothane and isoflurane significantly. In conclusion, we have shown that we can obtained more rapid induction and recovery of inhalation anesthetics with lower solubility of anesthetics. In addition, with increased fresh gas flow and use of gas mixture af nitrous oxide, induction and recovery of anesthetics will be more rapidly.
Adult ; Anesthetics* ; Anesthetics, Inhalation ; Enflurane ; Halothane ; Humans ; Isoflurane ; Lung ; Nitrous Oxide ; Oxygen ; Solubility ; Ventilation

We recently observed a pancreatic islet cell adenoma with nesidioblastosis in a neonate which was confirmed after subtotal pancreatectomy. A nesidioblastosis, a term coined by Laidlaw in 1938 to describe the neoformation of islet tissue by differentiation of tortipotent pancreatic duct cell, is extremely rare as a cause of neonatal hypoglycemia. Persistent hypoglycemia which was temporarily responsive to hypertonic glucose therapy, convulsion, and apnea were noted frequently. Blood insulin level was elevated inappropriately with respect to the blood glucose level. Preoperative CBC, urinslysis, chest X-ray, serum electrolytes, and ECG were normal except low blood glucose leve(21mg%). The patient was not permedicated. With infusion of 15% D/W, anesthesia was induced by tracheal intubation with 3mg/kg of succinylcholine and was maintained by controlled ventilation with O2(3L/min)-N2O(3L/min)-halothane(1%) and pancuronium. Hyperglycemia and hypoinsulinemia were developed after pancreatectomy, these were controlled satisfactorily by administration of regular insulin. The patient was discharged with normal blood glucose level and no requirement of insulin at 38 days of postoperation.
Adenoma ; Anesthesia ; Apnea ; Blood Glucose ; Electrocardiography ; Electrolytes ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Intubation ; Islets of Langerhans ; Nesidioblastosis* ; Numismatics ; Pancreatectomy ; Pancreatic Ducts ; Pancuronium ; Seizures ; Succinylcholine ; Thorax ; Ventilation