No abstract available.
HIV* ; Humans*

Paget's disease is classified, according to location, as mammary or extramammary disease. Extramammary Paget's disease especially in the vulva is extremely rare. Several hundred cases have been described worldwide. Patients with Paget's disease of the vulva are usually white and postmenopausal. The cause of which remains elusive. A case of vulva Paget's disease is presented with brief review of literature.
Humans ; Paget Disease, Extramammary ; Vulva

PURPOSE: To evaluate the usefulness of the helical CT in the differentiation of periampullary malignanttumors. MATERIALS AND METHODS: Fifty-five periampullary carcinoma patients (pancreatic head carcinoma (n=18);distal CBD carcinoma (n=17) ; carcinoma of the ampulla of Vater(n=16) ; periampullary duodenal cancers,(n=4), alldiagnosed by histopathologic study] underwent helical CT with 5mm scan thickness and 5mm/sec table speed. Afterscanning, retrospective reconstruction was performed at 2mm intervals, followed by multiplanar reformation. Inboth retrospective reconstructed axial and multiplanar reformation images, the authors analyzed the detection rateand size of the mass, and associated findings including invasion of peripancreatic fat, dilatation of CBD and itsnarrowing pattern, dilatation of the pancreatic duct and its degree of dilatation, wall thickening of CBD,extension of dilated bile duct into the ampulla, and of protruding mass into the duodenal lumen, and lymph nodemetastasis all according to the origin sites of tumors. Differential points were thus determined. RESULTS: Thedetection rate of the masses was 96% (53/55). Their size was 1-5cm, with a mean size of 2.4 +/-0.5cm in carcinomaof of ampulla of Vater and 3.5 +/-1.0cm in pancreatic head carcinoma. Invasion of peripancreatic fat was mostcommonly observed in pancreatic head carcinoma (100%, 18/18) (P >0 . 0 5 ), dilatation of CBD was observed in allcases except one of periampullary duodenal cancer (98%, 54/55), and abrupt termination of dilated bile duct wasnoted in all cases except one of the pancreatic head carcinoma (98%, 53/54). Dilatation of pancreatic duct wascommonly observed in pancreatic head carcinoma (94%, 17/18) and carcinoma of the ampulla of Vater (75%, 12/16).Its degree of dilatation was mostly moderate in pancreatic head carcinoma (56%, 10/18) and mostly mild incarcinoma of the ampulla of Vater (63%, 10/16) ( P >0.05). Wall thickening of the distal CBD was most commonlyobserved in distal CBD carcinoma (76%, 13/17). Extension of dilated bile duct into the ampulla was commonlyobserved in the carcinoma of the ampulla of Vater (81%, 13/16) and periampullary duodenal cancer (75%, 3/4) (P>0.05). A mass protruding into the duodenal lumen was commonly observed in periampullary duodenal cancer (100%,4/4) and carcinoma of the ampulla of Vater (94%, 15/16) (P >0.05). Lymph node meatastasis was observed inpancreatic head carcinoma (17%, 3/18) and distal CBD carcinoma (6%, 1/17). CONCLUSION: Because of improvement inthe rate at which the mass is detected, and a clear demonstration of associated findings, helical CT is useful inthe differentiation of periampullary carcinomas.
Ampulla of Vater ; Bile Ducts ; Diagnosis* ; Dilatation ; Duodenal Neoplasms ; Head ; Humans ; Lymph Nodes ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed*

A review has been made of 500 cases of which had been undertaken fundoscopic and slit lamp examination. Senile cataract in diabetics tends to be associated with diabetes of long duration. They were analyzed according to sex, age, duration, fasting blood sugar level, visual acuity and fundus findings. The results are obtained as follows. 1. Incidence of cataract among 500 cases of diabetics is 41%. 2. Prevalence of cataract is significantly associated with duration of diabetes(P<0.005). 3. Prevalence of cataract is significantly associated with age over 40. 4. Prevalence of cataract is significantly correlated with FBS level with duration of diabetes of under 5 years(r=0.8). 5. prevalence of cataract is significantly associated with visual acuity(p<0.005). 6. Diabetic Retinopathy was found in 50% of those with cataract
Blood Glucose ; Cataract* ; Diabetic Retinopathy ; Fasting ; Incidence ; Prevalence ; Visual Acuity

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

PURPOSE: Fat embolism syndrome is caused by traumatic and nontraumatic conditions, and most commonly associated with fractures of long bones of the lower extremity. Clinical manifestation of the fat embolism syndrome occurs in a minority of patients with fat emboli. The incidence of fat emboilsm has been reported 5-10%. The pulmonary symptoms of fat embolism are clinically important but hard to diagnose, so treatment was often delayed. The purpose of this study is to search for the development of fat embolism after long bone fracture of rabbit, and to demonstrate pulmonary fat embolism by high resolution computerized tomograhy (HRCT) and pathologic findings. MATERIALS AND METHODS: Twelve rabbits (Newzealand, 2.5-3 Kg) were divided into 2, 24, 72 hours and control groups after closed tibiofibular fracture. The presence of involvement was classified by high resolution computerized tomography with ground glass opacity, consolidation and focal hyperlucency. The extent was measured by 10% grading scale. Gross inspection, histologic examination and histochemistry (Oil red 0) were performed in removed lungs. RESULTS: Ground glass opacity was found in 100% of test subjects, consolidation was found in 89%, bronchovascular bundle thickening was found in 78% and focal hyperlucency was found in 33%. Fat embolism was developed in all groups with the 24-hour group showing maximal changes. Microscopically the vessel was occluded with fat globule which was stained with Oil red 0 stain. CONCLUSIONS: The abnormal density lesion on HRCT was correlated with pathologic finding and was induced by fat emboli after long bone fracture of the rabbit
Embolism, Fat* ; Fractures, Bone* ; Glass ; Humans ; Incidence ; Lower Extremity ; Lung ; Pathology ; Rabbits

The management of fractures of the intercondylar eminence of the tibia is uncomplicated when the fracture has minimal displacement(type I) or when only anterior one-third or half of the eminence is elevated(type II)(Meyers and Mckeever 1959, 1970). The treatment of complete separation(type III) has been controversial. Many authors however recommended conservative treatment even for the completely separated fracture if the fracture fragment is not rotated. Two cases of non-union of the tibial spine fracture we experienced were; one in type IIl, and the other type II. They were treated conservatively by cast immobilization. One patient had severe anterolateral rotatory.instability and had lateral meniscal tear, and the other had transverse ligament impingement at the fracture gap which interfered the reduction of the fragment and also bony union. Through the clinical experience and the two listed non-union cases, we drafted a therapeutic plan for the avulsed tibial spine fractures. The authors recommend open reduction and internal fixation of the avulsion fracture of the tibial spine in following circumstance; 1) all of the type K complete separation injuries 2) tibial spine fracture with positive Lachman test and soft end point 3) fracture with associated ligament injury. We applied the above surgical indications for 13 cases. The authors reviewed 25 cases of the anterior tibial spine fracture patients treated at the Department of Orthopaedic Surgery, Catholic Unviersity Medical College during the period from October 1982 to August 1986 and the following results were obtained. 1. The cases were classified into 3 different categories according to the Meyers and Mckeever classification; Type I(7 cases, 29%), Type II(10 cases, 40%), Type III(8 cases, 31%). 2. Associated ligament injuries on the same knee were rupture of LCL for 7 cases(28%) and MCL for 6 cases(24%). 3. Twelve out of thirteen open reduction and internal fixation cases had excellentresult in minimum 6 months follow-up period.
Classification ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Rupture ; Spine ; Tears ; Tibia

Background: Studies on prevalence and social variables affecting postpartum depression appear to be inconsistent. This study aimed to examine the prevalence of postpartum depression, as well as the correlation between education, offspring, age, and risk of the postpartum depression. Methods: This study included 144 mothers living in Chungju who appeared to experience postpartum depression based on a score of >10 marks on the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Correlation and logistic regression analyses were used to calculate correlation coefficients and odds ratios (OR) for postpartum depression based on the education level of mothers and number of offspring. Results: Prevalence of postpartum depression was found to be 29.17%. Age was not significantly correlated with EPDS score. EPDS scores tended to decrease with the increase in the number of education years (OR, 0.66); however, EPDS scores tended to increase with the increase in the number of offspring increased (OR, 1.65). Conclusion The result of this study demonstrates that education acts as a protective factor and number of offspring acts as a risk factor for postpartum depression. It also suggests that proper intervention in the mothers’ educational level and number of offspring is necessary.

OBJECTIVES: This study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study. METHODS: In total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs). RESULTS: Of the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women. CONCLUSIONS The effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.

No abstract available.
Teratoma*