OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

No abstract available.
Female ; Ovary* ; Ultrasonics*

Papillary eccrine adenoma is a rare sweat gland tumor with a characteristic histopathological appearance and has a benign clinical course. Five cases were reported in Korea since a report by Song et al. in 1988. We report a case of papillary eccrine adenoma in a 38-year-old male who had a firm, dark brown nodule on the medial surface of the left thigh. Microscopically, the tumor was composed of multiple dilated ducts lined by two or more layers of epithelial cells and the luminal cells showed papillary projections into the lumen in some tubules. Immunoperoxidase staining was positive for CEA, S-100, and EMA. We excised the lesion completely and no evidence of recurrence was observed for 6 months.
Adenoma* ; Adult ; Epithelial Cells ; Humans ; Korea ; Male ; Music ; Phenobarbital ; Recurrence ; Sweat Glands ; Thigh

Norfloxacin is a new broad spectrum of antibacterial activity against both Gram-positive and Gram. negative bacteria. After oral administration of Norfloxacin, it produces high concentrations in the urine, so it has the excellent effect for the treatment of urinary tract infection. Norfloxacin was studied with respect to clinical effect in 115 patients with the urinary tract infection and the following results were obtained. 1. Excellent efficacy was 53% and efficacy rate was 90% in upper urinary tract infection(UTI). Efficacy rate for 20 patients with upper UTI without the underlying disease was 100%, and in 29 patients with underlying disease efficacy rate was 83%. 2. In upper UTI resistant for other antibiotics, efficacy rate was 78%. 3. In lower UTI excellent efficacy rate was 36% and efficacy rate was 71%. In gonococcal urethritis excellent efficacy rate was 76% and efficacy rate was 88%. 4. Eliminated rate of bacteria on culture findings were E. coli 93%, pseudononas 89%, proteus 100%, klebsiella 80%, gonococcus 88% and staphylococcus 80%. 5. Mild side effects such as epigastric pain, nausea, dizziness and itching sensation were seen in 5 cases. We consider Neutam-400 is one of the most effective agents in urinary tract infection.
Administration, Oral ; Anti-Bacterial Agents ; Bacteria ; Dizziness ; Humans ; Klebsiella ; Nausea ; Neisseria gonorrhoeae ; Norfloxacin ; Proteus ; Pruritus ; Sensation ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Cellular schwaninoma is a variant of schwannoma, which is characterized by predominance of cellular Antoni A area, presence of mitotic activity, nuclear hyperchromasia, pleomorphism, and absence of Verocay body. These pathologic features often prompted a misdiagnosis of malignancy. However, the clinical outcome has indicated the benignity of the tumor. We have experienced a case of cellular schwannoma arising from right facial nerve with right hemifacial weakness and erosion of mastoid process. Grossly, it was a 3.5 x 3 cm sized and relatively well encapsulated mass with yellowish, friable cut surface. Microscopically, cellular growth with moderate cellular pleomorphism and some mitotic activity (5/40 HPFS, up to 2/HPF) were noted. Immunostaining for S-100 protein showed diffuse strong positive reaction.
Diagnostic Errors ; Facial Nerve* ; Mastoid ; Neurilemmoma* ; S100 Proteins

This study examined the effectiveness of two commonly used dietary assessment methods (the 24-hour recall and the food frequency questionnaire) in the epidemiological investigations of health-related habits and degenerative diseases. This cross sectional project in the Seoul area was conducted for the purpose of establishing cohort subjects and collecting reliable nutrient intake data for a further large-scale cross sectional study. The subjects were 91 volunteers from the Seoul area with a mean age of 53.5 +/- 9.6 for the males and 52.2 +/- 8.9 for the females. The subjects had a rela-tively high educational background, were from high socioeconomic levels, and were greatly concerned about healthrelated life styles. There was a significantly negative correlation between their smoking and their nutrient intake. Their drinking habits, their self-estimated health status and their concern or stress about being healthy did not have any influence on their nutrient intakes. Skipping meals was the most undesirable dietary habit influencing their nutrient intakes, and the next was their irregularity of eating meals. The subjects who liked legumes and fish had higher intakes of iron and niacin and those who liked milk and dairy products had higher intakes of calcium, vitamin B2 and fat. The subjects who considered themselves not to be healthy consumed higher amounts of fish and shell-fish, and those who considered themselves to be healthy consumed higher amounts of vegetables. The smokers consumed less fruits than non-smokers, but there was no correlation between their drinking and consumption of the food groups. There was no correlation between their food consumption frequency and their skipping meals or meal irregularity. There were positive correlations between their food likes and food consumption frequency for foods such as meat, milk and dairy products, seaweeds and fruits. Therefore, their smoking, skipping meals and meal irregularity appeared to greatly influence their nutrient intakes. Significant correlations were found between their health-related habits and their food group preferences and food frequencies. This implies that simple surveying methods using criteria such as smoking, skipping meals and meal irregularity, food group preferences and eating frequencies can be used as useful tools in the assessment of nutritional statuses.
Calcium ; Cohort Studies ; Dairy Products ; Drinking ; Eating ; Fabaceae ; Female ; Food Habits ; Fruit ; Humans ; Iron ; Life Style ; Male ; Meals ; Meat ; Milk ; Niacin ; Nutritional Status ; Riboflavin ; Seoul* ; Smoke ; Smoking ; Vegetables ; Volunteers

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE 111 scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE 111 score rised (P<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. when the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. when we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (P<0.05).
APACHE* ; Busan ; Humans ; Intensive Care Units* ; Critical Care* ; Mortality ; Prospective Studies ; Secondary Care ; Tertiary Healthcare

No abstract available.
Amenorrhea* ; Female

This is a retrospective study of 161 ovarian neoplasms, all of which were surgically removed and had preoperative sonographic examinations. They were evaluated respect to age, tumor size and its echogenicity. The results were as follows: 1. Of all 161 tumors, physiologic lesions were 67 cases (41.6%), germ cell tumors were 28 cases (17.4%) and serous tumors were 19 cases (11.8%). 2. Of all 161 tumors, right ovarian lesions were 82 cases (50.9%), left were 59 cases (36.7%), and bilateral lesions were 20 cases(12.4%). 3. The most characteristic findings of tumors were as follows: 1) Physiologic tumors were 2-9cm sized (88.1%), anechoice-5% echogenic (79.1%), and developed during 4th & 5th decades (91.0%). 2) Inflammatory tumors were 2-9cm sized (94.1%), 50%-totally echogenic (76.5%), and during 4th & 5th decades (94.1%). 3) Serous tumors were 2-9cm sized (60.3%), anechoic-5% echogenic (89.5%), and during 3rd & 4th decades (84.2%). 4) Mucinous tumors were 5-19 cm sized (77.8%), anechoic-5% echogenic (77.8%), during 2nd-8th decades with diffuse distribution. 5) Endometrioid tumors were 5-14cm sized (100.0%), variable echogenic, and during 3rd & 4th decades (90.9%). 6) Germ cell tumors were 5-14cm sized (75.0%), variable echogenic, during 3rd & 4th decades (82.1%). 7) Parovarian cysts were 2-14cm sized (90.0%), anechoic-5% echogenic (100.0%), with diffuse age distribution. 4. The malignant and borderline malignant tumors were 9 caseswith more than 10cm sized (77.8%), and developed during older than 4th decade (100.0%). Anechoic 3 cases, 1-5% echogenic 2 cases, and totally echogenic 4 cases were found.
Age Distribution ; Female ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Ovarian Neoplasms ; Parovarian Cyst ; Retrospective Studies ; Ultrasonography

This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5+/-9.6 for the males and 52.2+/-8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B1 and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B1, vitamin B2 and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation.
Aging ; Calcium ; Cholesterol ; Cohort Studies ; Education ; Energy Intake ; Female ; Humans ; Iron ; Male ; Nutritionists ; Postal Service ; Prospective Studies ; Riboflavin ; Seoul ; Sodium ; Telephone ; Thiamine ; Vitamin A ; Vitamins ; Volunteers