No abstract available.
Catheters* ; Ventriculoperitoneal Shunt*

PURPOSE: The purpose of this seroepidmiologic study was to examine the immunization and infection history of rubella, positivity of rubella specific antibody, seroconversion rate of two rubella vaccines and to develop an adequate immunization program of rubella. Research Methods : Subjects of the study were 2.071 students of 8 priamary schools in Gyenggi-Do. Questionnaire and blood sampling were done. Test method of Rubella specific antibody was ELISA (Abbott IMx autoanalyzer). The anayltic methods for the study were chi-square-test, t-test and ANOVA. RESULTS: The results of the study were as follows : (1)The number of subjects who had infection history of rubella were only 28 students(1.5%). (2)The immunization rate of rubella was the highest in 6 year-old group(65%), it decrease as subjects grow older. (3)The positivity of rubella antibody was 76. 6%, it is the highest in 6 year old group and the lowest in 7 year-old group and it increase again as subjects grow older. (4)Average antibody titer was 53.3 IU(SD 79.2), the trend of antibody titer by age was similar to that of positivity. (5)The seroconversion rates of both vaccines, vaccine A,vaccine B, were 99.5% and 99.6%, the ratio of increase of antibody titer after immunization was higer than 400. it means that both vaccines are very efficacious. CONCLUSION: Results of the study suggest that it is necessary to increase the coverage of rubella immunization, and further studies are necessary to get more information for rubella.
Child ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunization Programs ; Rubella* ; Seroepidemiologic Studies* ; Vaccines ; Surveys and Questionnaires

BACKGROUND: Epidural steroids injections are often used for the treatment of low back pain but their effects on the endocrine system have not been determined. Few studies have quantified the degree or duration of the suppression of the hypothalamic-pituitary-adrenal (HPA) axis in humans given epidural triamcinolone injection (ETI) for low back pain. The evaluation of the blood adrenocorticotropic hormone (ACTH) and cortisol was undertaken to determine the extent of suppression of the HPA axis in patients given ETI. METHODS: Lumbar epidural triamcinolone injections were performed on the painful lumbar intervertebral space with patients in the lateral decubitus position. The injection consisted of 40 mg of triamcinolone acetonide diluted in 10 mL of 1% lidocaine. Patients remained in the lateral position for 10 min after the procedure. Basal blood sampling was performed at 30 min before ETI and tested blood sampling was obtained at 7 days, 10 days, and 14 days after ETI. RESULTS: The blood cortisol level was significantly decreased at 7 days and 10 days but at 14 days was not significantly decreased and the blood ACTH level was not significantly decreased at 7 days, 10 days, and 14 days. CONCLUSIONS: Above results demonstrate that blood ACTH and cortisol level normalize 7 days and 14 days, respectively, after epidural triamcinolone 40 mg injection.
Adrenocorticotropic Hormone* ; Axis, Cervical Vertebra ; Endocrine System ; Humans ; Hydrocortisone* ; Lidocaine ; Low Back Pain ; Steroids ; Triamcinolone Acetonide ; Triamcinolone*

The retrospective study was taken to study the serum transaminase level and it's correlation with several symptoms in human rotavirus gastroenteritis. 494 children, who admitted to the Department of Pediatrics in Dae Dong Hospital from January 1991 to December 1991 with chief complaints of waterdy diarrhea were included in studies. The 1st stool specimen on admission was tested for rotavirus Ag by ELLSA method. and than serum transaminase were checked. The results are as follows: 1) The peak incidence being between 6 months to 2 years in both group, but higher incidence was noted in Non-HRV group. Males are more common than females by ratio of about 2:1. 2) The major symptoms in order of frequency was diarrhea>dehydration>vomiting>coughing>fever in HRV group, diarrhea>dehydration=vomiting>fever>coughing in Non-HRV group. The incidence of dehydration and coughing in HRV group were higher than in Non-HRV group. 3) AST & ALT elevation above the normal value were 83.2% (213/256), 52.0% (133/256) in HRV group and 45.3% (116/238), 22.3% (57/238) in Non-HRV group. AST & ALT were significantly increased in HRV group than Non-HRV group (AST: p<0.05, ALT: p<0.05). 4) Mean concentration of AST & ALT were 46. 82, 38.06 in HRV group and 29.06, 21.23 in Non-HRV group. Mcan concentration of AST & ALT were significantly increased in HRV group than Non-HRV group (AST: p <0.05, ALT: p<0.05). 5) Mild dehydration is relatively more common in both group. The frequency were 56.6% (145/256) in HRV group, 47.5% (113/238) in Non-HRV group. The degree of dehydration was not correlated with serum transaminase level at each group(HRV group: p>0.05, Non-HRV group: p>0.05). 6) Duration of diarrhea for 4-5 days & 1-3 days were relatively more common in HRV group than Non-HRV group. The frequency were 36.3% (93/256) in HRV group and 34.9% (83/268) in Non-HRV group. The degree of diarrhea were not correlated with serum transaminase level at each group (HRV group: p>0.05, Non-HRV group: p>0.05). 7) No fever or duration of fever for 1-2 days were relatively more common in both group. The frequency were 39.9% (102/256), 37.5% (96/256) in HRV group and 38.2% (91/238), 42.5% (101/238) in Non-HRV group. The degree of fever was not correlated with serum transaminase level in HRV group, but correlated with Non-HRV group (HRV group: p>0.05, Non-HRV group: p<0.05).
Child* ; Cough ; Dehydration ; Diarrhea ; Female ; Fever ; Gastroenteritis* ; Humans ; Incidence ; Male ; Pediatrics ; Reference Values ; Retrospective Studies ; Rotavirus

Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained. On analyzing the quality of the ground water on patients's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analyzing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.
Bacteria ; Chickens ; Cyanosis ; Diarrhea ; Drinking ; Drinking Water ; Family Characteristics ; Fertilizers ; Groundwater ; Hematologic Tests ; Humans ; Infant* ; Manure ; Methemoglobin ; Methemoglobinemia* ; Plants ; Potassium ; Residence Characteristics ; Seoul ; Water ; Water Supply

Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

Since in 1963 Waters first described the techniques of guiede blind tracheal intubation to solve the problem of difficult in airway maintenance in patients who have deformity of the upper jaw, several methods are recommended to overcome a difficult intubation. We experienced successful retrograde endotracheal intubation without significant complications as follows. Using loca anethesia, 16G Tuohy needle was passed through the anterior wall of the trachea 1.5 to 2.0 cm below the cricoid cartilage in the midline. The needle was directd upward foward the larynx and the epidural catheter was insertedc through it and advanced retrograde between the vocal cords and into mouth or nose. The endotracheal tube was threaded over the catheter and the proximal end of the catheter was clamps by kelly forceps. By keeping the catheter taut and coincidently pulling back, the tube was adnvanced in to trachea.
Catheters* ; Congenital Abnormalities ; Cricoid Cartilage ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Larynx ; Mouth ; Needles ; Nose ; Surgical Instruments ; Trachea ; Vocal Cords

It is a well known fact that obesity is an important cause of cardiovascular disease, emphasized by many studies. Recently, cardiovascular diseaase has been found to correlate not only to the extent of obesity, but also the fat distribution of the individual; especially, focusing on obesity of the abdomen. Unfortunately, the proposed indices for abdominal obesity are numerous, and the results vary according to the index chosen. Three-hundred and twelve bus drivers in November, 1995, were chosen as subjects of this study. The author chose to measure serum lipid levels, fasting blood sugar levels and blood pressure, that are thought to be important risk factors of cardiovascular diseases. Obesity indices were calculated using anthropometric measurements. We were able to evaluate the significance of obesity indices by examining correlations between these indices and the risk factors of cardiovascular disease. The results obtained were as follows: 1. The abdominal obesity indices and risk factors of cardiovascular disease, the levels of total cholesterol in the serum, fasting blood sugar levels, and diastolic blood pressure, increased significantly according to age. 2. There was a significant difference in the abdominal obesity indices according to drinking and smoking habits controlled for age. Among the risk factors of cardiovascular disease, triglyceride and diastolic pressures had significant differences according to the presence or absence of a drinking history controlled for age. 3. Although all obesity indices showed significant correlations, the weakest correlation was between BMI and abdominal diameter index and the strongest correlation was between sagittal diameter and sagittal diameter matched for height. 4. There was a negative correlation between HDL-cholesterol and obesity indices. The weakest correlation was between fasting blood sugar levels and both SD and SDH showed correlations with the risk factors. 5. There was a significant correlation between SD and total cholesterol in the serum and fasting blood sugars controlled for age, drinking, and BMI. 6. After categorizing the subjects into 2 separate age groups at the 40 year mark, in the less than 40 year old age group, controlled for drinking and BMI, the results of comparitive studies have shown correlations between total cholesterol serum levels and waist-hip ratio, conicity-index, and SD. There were correlations between fasting blood sugar levels and SD, ADI, and SDH. There were no correlations between obesity indices and both total cholesterol serum levels and fasting blood sugar levels in the greater than 40 year old age group. There were significant correlations between abdominal obesity indices and total serum cholesterol or fasting blood sugar levels in the less than 40 year old age group, but no correlations in the age group over 40. These correlated factors between abdominal obesity and cardiovascular disease are assumed to exist in Korea as well. Furthermore, in this study a high correlation was found between SD, SDH and the risk factors of cardiovascular disease. Even when controlled for age, drinking, smoking, and BMI, the correlations between risk factors of cardiovascular disease and these indices exist. Therefore, the obesity indices, SD and SDH may prove to be important prognostic indicators or risk factors of cardiovascular disease
Abdomen ; Adult ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Drinking ; Fasting ; Humans ; Korea ; Obesity* ; Obesity, Abdominal* ; Risk Factors* ; Sagittal Abdominal Diameter ; Smoke ; Smoking ; Triglycerides ; Waist-Hip Ratio

PURPOSE: Intussusception is a very common pediatric problem and needs early management. This study evaluated the risk factors of intussusception in infants and children for early diagnosis and treatment. METHODS: 216 cases of pediatric intussusception occurring between 1993 and 1999 in Mokpo Catholic Hospital were investigated retrospectively. 164 patients treated with barium reduction comprised the barium reduction (BR) group and 52 patients treated with manual reduction or bowel resection was operation (OP) group. RESULTS: The age incidence under 1 year old was 108 patients (65.9%) in BR group, 45 patients (86.5%) in OP group. Male to female ratio was 1.8:1 in BR and 1.7:1 in OP, respectively. In the seasonal distribution spring was more common in both group (34.1%, 34.6%). 60.4% in BR group, 76.9% in OP group were revealed leukocytosis above 10.000/mm3 in serum. Previous combined diseases were upper respiratory infection (31.7%, 42.3%), acute gastroenteritis (1.2%, 1.9%) and multiple familial polyposis (0.5% in BR group). The frequent symptoms and signs were bloody stool (86.0%,92.3%), abdominal pain and irritability (86.6%, 82.7%), vomiting (76.9%, 67.3%), and abdominal mass (56.7%, 76.9%). Tachycardia was 12.2% in BR and 44.2% in OP. In plain abdominal radiography, intestinal obstructive pattern was present in 5.5% of BR group and 53.8% of OP group. Success rate of barium reduction within 24 hours after symptom appearance was 82.3%. Within 24-48 hours was 61.1%, above 48 hours was 25%. There was a statistically significant difference between BR group and OP group of patients under 1 year old, with tachycardia, symptoms for longer than 48 hours and obstructive pattern on plain abdominal radiography (p<0.05). Of surgical cases, 84.6% were idiopathic. The common anatomical type was ileo-colic type (53.9%). The methods of operation were manual reduction (94.2%) and bowel resection (5.8%). Postoperative complications occurred in 4 cases; 3 cases of wound infection and 1 case of pulmonary complication. Recurrence rate was 12.8% in BR group. CONCLUSION: Risk factors of high incidence such as under 1 year old, severe obstructive pattern on the plain abdominal radiograph, symptoms for longer than 48 hours, and tachycardia, were related with a low success rate of barium reduction. Therefore, a gentle barium enema is recommended in high risk patients for diagnosis and prompt surgical intervention.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Early Diagnosis ; Enema ; Female ; Gastroenteritis ; Humans ; Incidence ; Infant* ; Intussusception* ; Jeollanam-do ; Leukocytosis ; Male ; Postoperative Complications ; Radiography, Abdominal ; Recurrence ; Retrospective Studies ; Risk Factors ; Seasons ; Tachycardia ; Vomiting ; Wound Infection

OBJECTIVES: The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. MATERIALS AND METHODS: Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. RESULTS: Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was 49.0+/-8.1 years, mean duration of admission was 17.27+/-10.51 days, mean costs for treatment was 1,970,000+/-475,000 won. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was 28.7+/-10.4 days, mean costs for treatment was 2,194,473+/-561,639 won. The periods of stabilization was 6.6+/-3.36 weeks on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14-patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was 11.24+/-3.29 days, mean costs for treatment was 1,850,823+/-389,372 won. The periods of stabilization was 5.88+/-7.07 weeks on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. CONCLUSIONS: The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.
Cost-Benefit Analysis ; Diskectomy ; Follow-Up Studies ; Humans ; Outpatients ; Transplants*