The authors examined 312 outpatients, including 100 with otorrhea, 144 with rhinorrhea and 68 with pharyngeal discharge. The pH of otorrhea was generally acid, except in 2 cases of diffuse otitis externa where the discharge was strongly alkalihe. Otorrhea in purulent otitis media was mucopurulent or purulent and was strongly acid. The pH of rhinorrhea ranged from 6.6 to 7.4, being generally weakly alkaline. In acute rhinitis, it was alkaline in half the cases; a tendency to greater alkalinity showed in cases of marked swelling of the inferior nasal conchae. In chronic paranasal sinusitis, the pH generally shifted to the acid side; in acute paranasal sinusitis and in nasal polyps, it was weakly alkaline in all cases; and in allergic rhinitis it was neutral with in a narrow range. the usual pH of oral and pharyngeal discharges ranged from 6.4 to 7.0, being generally weakly alkaline. The character of inflammatory discharges was serous or mucous in all cases, except for a case of peritonsillar abscess with mucopurulent discharge; the pH was weakly alkaline in 5 cases (7.4 per cent), neutral in 26 (38.2 per cent), and acid in 37 (54.4 per cent). When these discharges changed in character from seromucous to purulent, their pH was lowered.
Humans ; Hydrogen-Ion Concentration* ; Nasal Polyps ; Otitis Externa ; Otitis Media, Suppurative ; Otolaryngology* ; Outpatients ; Peritonsillar Abscess ; Rhinitis ; Sinusitis ; Turbinates

BACKGROUND: As people have been interested in healt,h and as the microcomputers with multimedia steeing have been supplied more and more, there is increasing need of multimedia information about health. The CD-ROM, which is a representative multimedia tool, is capable of interacting between information-provider and users, offering audiovisual interface, and saving great deal of knowledge. METHODS: We developed the health-information system to provide ordinary people with hea1th information using multimedia tools. It, has 7 parts ; self-diagnosis, exploring human body, drug information, hospital information, first-aid treatment, Q and A, and medical common sense. We got image data such as figures, photos, X-rays, electrocardiograms and pathologic specimens with scanner and film scanner, also moving image(video) with video-capturing program. RESULTS & CONCLUSIONS: We hope the multimedia health-information system to become a useful methodology of patient education and to be used as an information source in medical information network in the near future.
CD-ROM ; Electrocardiography ; Hope ; Human Body ; Information Services ; Microcomputers ; Multimedia* ; Patient Education as Topic

BACKGROUND: Phadiatop test which was developed for screening of atopy in eastern asia area, has not been sufficiently evaluated in Korea. In our previous study, the clinical usefulness of Phadiatop test for screening of atopy was evaluated on atopics and non-atopics defined by the results of skin prick tests with 10 inhalant allergens in Korea. In this study, we evaluated the usefulness of Phadiatop test for screening of atopy based on the level of CAP specific IgE in Korean asthmatics. METHODS: On 136 Korean asthmatics, the level of CAP specific IgE to 10 important inhalant allergens and the level of Phadiatop specific IgE to mixture of 8 important inhalant allergens in Korea were measured. Atopics and non-atopics were defined by the results of CAP specific IgE and the sensitivity, specificity, predictive value of a positive and negative result, and concordance rate of Phadiatop test were estimated. RESULTS: The sensitivity, specificity, predictive values of a positive and negative result, and concordance rate of Phadiatop test were 90.5%, 95.0%, 99.1%, 63.3%, and 91.2%, respectively. CONCLUSIONS: Phadiatop test was very sensitive, rapid and convenient, and corresponded well to the results of CAP specific IgE. We concluded that Phadiatop test is very useful as a screening tool of atopy in Korea.
Allergens ; Asthma ; Far East ; Immunoglobulin E* ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Skin

No abstract available.

Recent progress in medical informatics enable to use various medical regardless of time or place, to make a diagnostic and therapeutic plan, with increasing need about health of general population. There are many homepages on the web, which provide medical common senses, hospital information. and medical counseling on the web. Virtual Hospital, which is comprehensive medical information system on the web, has medical counseling program with various health information such as self-diagnosis, first-aid treatment information, drug information, Q and A, and so on. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 277 counsels which visited 'Medical Counseling' in the Virtual Hospital for December 1996 through May 1997. Many questioners wanted to consult about their symptoms, to know prevention and treatment strategies, and to know specific medical knowledge. The most common questions are as follows: general and unspecified, digestive, musculoskeletal, and skin problems. These findings suggest medical counseling may be used to supplement the lack of direct medical Interviews with doctors.
Computer Communication Networks ; Counseling* ; Information Systems ; Internet* ; Medical Informatics ; Skin

The FK506 binding protein 5 (FKBP5) is a co-chaperone that regulates the activity of the glucocorticoid receptor (GR) and has been reported to mediate stress resilience. This study aimed to determine the effects of Fkbp5 deletion on acute stress-induced recognition memory impairment and hippocampal GR signaling. Wild-type and Fkbp5-knockout mice were subjected to acute uncontrollable stress induced by restraint and electrical tail shock. First, we assessed the cognitive status of mice using a novel object recognition task. Next, we measured plasma corticosterone, GR levels, and the levels of GR phosphorylation at serine 211 in the hippocampus. Wild-type mice exhibited stress-induced memory impairments, whereas Fkbp5-knockout mice did not. Plasma corticosterone and GR levels did not differ between the non-stressed wild-type and Fkbp5-knockout mice, but the levels of phosphorylated GR were lower in Fkbp5-knockout mice than in wild-type mice. Wild-type and Fkbp5-knockout mice showed increased nuclear GR levels following stress, indicating GR translocation. However, cytosolic phosphorylated GR levels were lower in the hippocampi of Fkbp5-knockout mice following stress than in those of wild-type mice. These results suggest that FKBP5 deficiency increases resilience to acute stress by altering GR signaling.

BACKGROUND & SIGNIFICANCE: Focal seizures are usually due to an underlying structural lesion of the brain but occasionally caused by metabolic disturbances such as nonketotic hyperglycemia (NKH). Reflex focal seizures associated with NKH have been reported. CASE: The 69 year-old man was admitted in our hospital due to clonic movements of the right leg. His seizures did not occur spontaneously but were provoked by active or passive movements and tactile stimulation of the affected leg. The convulsive movements of the right leg often spread to the left leg without involving any other parts of his body. The seizures regressed with the control of hyperglycemia only. COMMENT: We report a patient presented with reflex focal seizures as the initial manifest-ation of NKH.
Aged ; Brain ; Humans ; Hyperglycemia* ; Leg ; Reflex* ; Seizures*

BACKGROUND: Gut microbiota contributes to intestinal and immune homeostasis through host-microbiota interactions. Distribution of the gut microbiota differs according to the location in the gastrointestinal tract. Although the microbiota properties change with age, evidence for the regional difference of gut microbiota has been restricted to the young. The aim of this study is to compare the gut microbiota between terminal ileum and cecum of old rats. METHODS: We analyzed gut microbiome of luminal contents from ileum and cecum of 74-week-old and 2-year-old rats (corresponding to 60-year and 80-year-old of human age) by metagenome sequencing of 16S rRNA. RESULTS: Inter-individual variation (beta diversity) of microbiota was higher in ileum than in cecum. Conversely, alpha diversity of microbiota composition was higher in cecum than in ileum. Lactobacillaceae were more abundant in ileum compared to cecum while Ruminococcaceae and Lachnospiraceae were more enriched in cecum. The proportions of Deltaproteobacteria were increased in cecal microbiota of 2-year-old rats compared to 74-week-old rats. CONCLUSIONS: Major regional distinctions of microbiota between ileum and cecum of old rats appear consistent with those of young rats. Age-related alterations of gut microbiota in old rats seem to occur in minor compositions.
Aged, 80 and over ; Aging ; Animals ; Cecum ; Child, Preschool ; Deltaproteobacteria ; Gastrointestinal Microbiome ; Gastrointestinal Tract ; Homeostasis ; Humans ; Ileum ; Lactobacillaceae ; Metagenome ; Microbiota ; Phenobarbital ; Rats

BACKGROUND: The medical service delivery system in Korea works inefficiently and patients tend to visit tertiary hospitals by means of the emergency department (ED). Overcrowding of the ED threatens the health and life of emergency patients as a result of the inability to effectively distribute emergency medical resources in the community. To solve this problem, improvement in the medical delivery system and dispersion of patients by strengthening primary care may be helpful. In order to make policy decisions for this, it is necessary to estimate the scale of patients who can be distributed to primary care.METHODS: From January 1 to December 31, 2016, we analyzed the National Emergency Department Information System (NEDIS) data of patients who visited a tertiary ED to examine the proportion of patients eligible for primary medical care. The inclusion and exclusion criteria for primary care were made through the consensus of three physicians.RESULTS: A total of 65,061 NEDIS records were analyzed. Among them, by inclusion criteria, 29,818 cases were Korean Triage and Acuity Scale level 4 and 5, and 11,791 patients visited the ED during the day. After considering the exclusion criteria, there were 6,468 cases who may be suitable for primary medical care.CONCLUSION: Of the patients who visited the ED of tertiary hospitals, approximately 10% of them may be suitable for primary care. There should be a discussion and social consensus to reduce overcrowding in EDs and deliver better medical services.
Consensus ; Emergencies ; Emergency Service, Hospital ; Humans ; Information Systems ; Korea ; Primary Health Care ; Tertiary Care Centers ; Tertiary Healthcare ; Triage

BACKGROUND/AIMS: Chronic hepatitis B infection is a common cause of secondary membranous nephropathy (MN) in endemic areas. Lamivudine treatment improves renal outcome in patients with hepatitis B virus-associated MN (HBV-MN), but prolonged use leads to the emergence of lamivudine-resistant variants. We describe our experience treating lamivudine-resistant and other strains of HBV-MN with new antiviral drugs. METHODS: Of the 89 patients biopsied and diagnosed with MN from 1996 to 2011, 10 positive for hepatitis B surface antigen were recruited for this study. We investigated the clinical courses, therapeutic responses, and prognoses of patients with HBV-MN. RESULTS: The incidence of HBV-MN among the original 89 patients was 11.2%. Of these patients, four were treated with supportive care and six with antiviral drugs. One of the four patients treated with supportive care had a spontaneous remission. Four of the six patients treated with antiviral drugs were given lamivudine, and the other two were given entecavir. Two of the four patients treated with lamivudine achieved complete remission with seroconversion (i.e., development of anti-hepatitis B e antigen antibodies), whereas the other two had lamivudine-resistant strains, which were detected at 22 and 23 months after lamivudine treatment, respectively. We added adefovir to the treatment regimen for one of these patients, and for the other patient we substituted clevudine for lamivudine. Both of these patients experienced complete remission, as did the two patients initially treated with entecavir, neither of whom showed resistance to the drug. CONCLUSIONS: New nucleoside analogues, such as entecavir, adefovir, and clevudine, can be effective for treatment of HBV-MN, including lamivudine-resistant strains.
Adenine/analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*therapeutic use ; Arabinofuranosyluracil/analogs & derivatives/therapeutic use ; Drug Resistance, Viral ; Female ; Glomerulonephritis, Membranous/*drug therapy/*etiology ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B, Chronic/*complications/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Organophosphonates/therapeutic use ; Young Adult