BACKGROUND: Administration of hepatitis B vaccine has played a major part in the management of public health in this country. There were many researches to assess the immunogenecity, safety, long term effectiveness, dose, and route of administration of hepatitis B vaccine. But there was lack of validation of the recommendation that hepatit.is B vaccine should be administered in adults with negative HBsAg and AntiHBs, in an endemic area with high prevalence of HBsAg. Authors tried to establish a proper candidate for hepatitis B vaccination evaluating viral markers of hepatitis B in adults vaccinated. METHODS: 172 hepatitis B vaccinated subjects(35.0%) were drawn from 491 adults who have visited at health care center, Asan Kangnung Hospital from April 1st to May 31th, 1997. They were asked designed questions about the beginning year, frequency of vaccination, and the presence of family members with HBsAg in a direct line. RESULTS: Of the subjects(172), 2.3% were HBsAg(+), 63.4% AntiHBs(+), 68.6% AntiHBc(+). Among the HBsAg(-) adults(149) who had been vaccinated more than three times, 70.4%(105) were AntiHBs(+), of whom 66.6%(70) were AntiHBc(+) and 29.6%(44) were AntiHBs(-), of whom 56.8%(25) were AntiHBc(+). In the subjects(20) with family history of HBsAg, 80% were AntiHBc(+), which is higher than 61.2% in the group(129) without family history. Among the HBsAg(-) and AntiHBc(-) adults(54) who had been vaccinated more than three times, AntiHBs(+) group was not significantly differnt from AntiHBs(-) group in comparison of age and years after initial vaccination. CONCLUSIONS: The two thirds(68.9%) of vaccinated subjects showed AntiHBc(+), which means reflection of previous exposure to Hepatitis B virus. Accordingly, vaccination is not thought to be required for these. Consequently, all individuals are thought to have to be pretested for the presence of AntiHBc as well as HBsAg and AntiHBs in Korea.
Adult* ; Biomarkers ; Chungcheongnam-do ; Delivery of Health Care ; Hepatitis B Surface Antigens* ; Hepatitis B Vaccines ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Prevalence ; Public Health ; Vaccination

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

No abstract available.
Emergencies* ; Humans

Natto, Traditional Japanese food fermented by Bacillus Natto, has been well known for a good nutritional food. However it has particular flavor, so most Koreans are not fond of it. That is the reason why, garlic(2%) and ginseng(2%) were added to make Natto, acceptable to Koreans. General soybean Natto(S1), 2% garlic Natto(S2), 2% ginseng Natto(S3) and blacksoybean Natto(S4) were prepared. The proximate composition revealed the most moisture content in S2 among the all samples. The most crude protein, crude fat and ash were found in S4. The non-fibrous and fiber contents were the most in S1 and S3. In the texture characteristics, hardness and gumminess were the highest in S4. The highest springness and cohesiveness were found in S1. Adhesiveness and chewing were the best in S2 and S3. The minerals composition revealed the most calcium content in S3 among the all samples. Fatty acid compositions were mainly consisted of linoleic acid(46.91~48.47%). In the sensory evaluation, S3 showed the best preference, appearance and color. In the aspects of taste and texture, S4 was mostly preferred. Flavor and viscosity of S2 were the best among the all samples. The general soybean Natto(S1) without any addition showed low values in most examinations and tests. In the sensory evaluation, S3 has the best overall acceptability among the all experimental Nattos.
Adhesiveness ; Asian Continental Ancestry Group ; Bacillus ; Calcium ; Garlic ; Hardness ; Humans ; Mastication ; Minerals ; Panax ; Soy Foods* ; Soybeans ; Viscosity

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness

In Albright's hereditary osteodystrophy (AHO) including the syndromes of pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP), multiple areas of intracutaneous ossification are often encountered. The characteristic features are short stature, round face, short neck, obesity, cutaneous ossifications, and various skeletal anomalies including short metacarpal and metatarsal bones, curve of radius, and brachydactyly. The patient was a 10-month-old male infant. He presented slightly depressed erythematous hard plaques on the left upper chest and left thigh. We had taken biopsies from both skin lesions, confirming cutaneous ossification or bone formation. He also had the characteristic features of AHO. He had a history of admission due to patent ductus arteriosus and atrial septal defect. The laboratory results showed slightly decreased calcium, increased phosphorus and PTH levels. The patient received no specific corrective measures because his calcium and phosphorus levels were not far from normal values until newly developed similar skin lesions appeared.
Biopsy ; Brachydactyly ; Calcium ; Ductus Arteriosus, Patent ; Heart Septal Defects, Atrial ; Humans ; Infant ; Male ; Metatarsal Bones ; Neck ; Obesity ; Osteogenesis ; Phosphorus ; Pseudohypoparathyroidism* ; Pseudopseudohypoparathyroidism ; Radius ; Reference Values ; Skin ; Thigh ; Thorax

OBJECTIVES: The aims of this study were to know whether Korean healthy elderly and family with dementia patients were wishing to disclose the diagnosis of dementia, to identify reasons of their wishing and unwishing to disclose, and to analyze influencing factors on the disclosing of dementia. METHODS: We obtained data from 78 healthy elderly with age over 60 and 73 family with dementia patients by interviewing with questionnaire about attitudes toward disclosing dementia. RESULTS: 1) 51.3% of healthy elderly and 58.9% of family with dementia patients were wishing to disclose dementia. Other relatives whom they wanted to tell were spouse or adult children. Most family with dementia patients wanted to have predictive tests in preparation for their future. 2) The main reasons for wishing to disclose were to make advance planning in healthy elderly, and to be careful and cooperate well to treat if they aware their illness in family with dementia patients (p<0.005, respectively). The main reasons for unwishing to disclose were whether they might be frightened or upset in healthy elderly (p<0.025), and to worry about being depressed in family with dementia patients (p<0.005). The main reasons why family wanted to be told were family's right to know and to explore treatment options. 3) The influencing factors on disclosing dementia seemed to be sex (p<0.01) and marital status (p<0.005) in healthy elderly, and education (p<0.005), marital status (p<0.005), religion (p<0.025) and socioeconomic status (p<0.01). CONCLUSION: The attitude toward disclosing diagnosis of dementia in Korean healthy elderly and family with dementia patients seemed to be more active. Therefore, doctors should prepare in mental attitude and knowledge to satisfy their need by active provision of information and education.
Adult Children ; Aged* ; Dementia* ; Diagnosis* ; Education ; Humans ; Marital Status ; Surveys and Questionnaires ; Social Class ; Spouses

BACKGROUND AND OBJECTIVES: Surfactant protein A (SP-A) which plays a role in the innate host defense of lung is also expressed in Eustachian tube. However the genes underlying the susceptibility to otitis media with effusion (OME) are known insufficiently. The current study attempts to evaluate the difference in the allele distribution of SP-A1 and SP-A2 between normal subjects and subjects with otitis media with effusion. SUBJECTS AND METHOD: PCR-cRFLP-based methodology was used to detect SP-A genotypes in the 38 children with OME, and in the 55 normal newborns for control. RESULTS: The frequencies of specific genotypes such as 6A(2), 1A(2) were increased in OME group, but the frequency of 6A3 was increased in control group. CONCLUSION: It is presumed that SP-A alleles may be inductive (6A(2), 1A(2)) or protective (6A(3)) factors for OME. Specific genoytypes of SP-A may be an important determinant for the predisposition to OME.
Alleles* ; Child ; Eustachian Tube ; Genotype ; Humans* ; Infant, Newborn ; Lung ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Pulmonary Surfactant-Associated Protein A*

No abstract available.
Meningitis ; Peptidyl-Dipeptidase A

Candida species is an uncommon pathogen and usually causes meningitis as a nosocomial infection. We report a case where a ventriculoperitoneal shunt was placed in a 72-year-old woman with hydrocephalus. Three months later, the patient was referred to the department of neurology due to fever and drowsiness. Candida parapsilosis was cultured in the cerebrospinal fluid as the causative agent of meningitis. Candida species should be considered as a pathogen when meningitis is present in severely ill patients with ventriculoperitoneal shunts.
Aged ; Candida* ; Cerebrospinal Fluid ; Cross Infection ; Female ; Fever ; Humans ; Hydrocephalus ; Meningitis* ; Neurology ; Sleep Stages ; Ventriculoperitoneal Shunt*