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

OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of cervical midline-splitting French-door laminoplasty with a polyether ether ketone (PEEK) plate. The authors retrospectively analyzed the results of patients with cervical laminoplasty miniplate (MAXPACER(R)) without bone grafts in multilevel cervical stenosis. METHODS: Fifteen patients (13 males and 2 females, mean age 50.0 years (range 35-72)) with multilevel cervical stenosis (ossification of the posterior longitudinal ligament and cervical spondylotic myelopathy) underwent a combined surgery of midline-splitting French-door laminoplasty with or without mini plate. All 15 patients were followed for at least 12 months (mean follow-up 13.3 months) after surgery, and a retrospective review of the clinical, radiological and surgical data was conducted. RESULTS: The radiographic results showed a significant increase over the postoperative period in anterior-posterior diameter (9.4+/-2.2 cm to 16.2+/-1.1 cm), open angles in cervical lamina (46.5+/-16.0degrees to 77.2+/-13.1degrees), and sectional volume of cervical central canal (100.5+/-0.7 cm2 to 146.5+/-4.9 cm2) (p<0.001). The sagittal alignment of the cervical spine was well preserved (31.7+/-10.0degrees to 31.2+/-7.6degrees, p=0.877) during the follow-up period. The clinical results were successful, and there were no significant intraoperative complications except for screw displacement in two cases. The mini plate constructs did not fail during the 12 month follow-up period, and the decompression was maintained. CONCLUSION: Despite the small cohort and short follow-up duration, the present study demonstrated that combined cervical expansive laminoplasty using the mini plate is an effective treatment for multilevel cervical stenosis.
Cohort Studies ; Constriction, Pathologic ; Decompression ; Ether* ; Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Longitudinal Ligaments ; Male ; Postoperative Period ; Retrospective Studies ; Spine ; Spondylosis* ; Transplants

No abstract available.
Coronary Vessels*

OBJECTIVES: The goal of this research was to attempt to examine ethnic and cultural differences in factors associated with disordered eating attitudes and behaviors. METHODS: Data were collected from the four groups of 3,129 high school students aged between 13 and 16 years who completed school-based survey conducted in 1996. The students(663 Korean urban, 821 Korean rural, 830 Korean-Chinese and 815 Chinese adolescents) completed an instrument which assessed weight, height, Body Mass Index(BMI), parental income, father's level of education, weight control questionnaire, Body Image Scale(BIS), and eating attitudes and behaviors using the Eating Attitude Test-26(EAT-26). RESULTS: BMI did not vary significantly by race, sex, and socioeconomic status. There were many severely underweight and severely overweight students among Korean-Chinese and Chinese than among Korean urban and Korean rural students. The EAT-26 mean scores of Korean-Chinese and Chinese subjects were significantly higher than those of Korean urban and Korean rural subjects. The EAT-26 mean score of Korean-Chinese was the highest among the four racial groups. The prevalence of high risk EAT-26(EAT-26> or =20) students of Korean-Chinese was 6.9% which was the highest among the four groups. The BIS mean scores of Korean rural and Korean urban subjects were significantly higher than those of Korean-Chinese and Chinese subjects. The Korean subjects were more dissatisfied with their body than the Chinese. The prevalences of weight control behaviors were 26.7% in Korean urban, 23.2% in Korean rural, 10.6% in Korean-Chinese, and 4.6% in Chinese subjects. Dieting and exercise were most popular for weight reducing in Korean subjects. Dieting and drug use were most popular in Chinese subjects. CONCLUSION: These data suggest that there must be many eating disorder patients in Korea and China, and the eating attitudes and behaviors are influenced by ethnic and cultural factors. Implications for understanding sociocultural influence on eating attitudes and behaviors and acculturation are discussed.
Acculturation ; Adolescent* ; Asian Continental Ancestry Group ; Body Height ; Body Image ; China ; Continental Population Groups ; Cross-Cultural Comparison* ; Diet ; Feeding and Eating Disorders ; Eating* ; Education ; Feeding Behavior ; Humans ; Korea ; Overweight ; Parents ; Prevalence ; Surveys and Questionnaires ; Social Class ; Thinness

PURPOSE: Drining of Nitrate-contaminated water has been the most common cause of acquired methemoglobinemia. We had cyanotic infant diagnosed as methemoglobinemia caused by feeding with powdered formula mixed with nitrate-contaminated ground water. METHODS: We had done epidemiologic investigation to identify the cause of an infant's methemoglobinemia. Analysis of ground water and blood test of involved family members and neighbors were performed RESULTS: Analysis of the 8 household ground water revealed high level of nitrate(29837 ppm), indicating contamination of water as the cause of methemoglobinemia. We had done blood tests to evaluate the methemoglobin level of 65 people in the neighborhood ; among them, there was no infant and we could not find another cyanotic case of methemoglobinemia. They had normal blood level of methemoglobinemic concentration. CONCLUSIONS: If ground water will be used for drinking water, especially for formula water, epidemiologic investigation and analysis of ground waters should be recommended.
Drinking Water ; Family Characteristics ; Groundwater* ; Hematologic Tests ; Humans ; Infant ; Methemoglobin ; Methemoglobinemia* ; Residence Characteristics

BACKGROUND AND OBJECTIVES: Previous studies have suggested that women with AMI are less aggressively managed than men. The aim of this study was to assess the differences between the sexes, in terms of the medical and invasive coronary procedures, in AMI patients during the 1990s, and the association to in-hospital mortality. SUBJECTS AND METHODS: In 1758 AMI patients, the baseline clinical characteristics, initial management and in-hospital outcomes, were studied. RESULTS: The women, on average, were older than men (68.8+/-10.6 versus 59.2+/-12.3, p<0.01), with a higher prevalence of diabetes and hypertension. Women received heparin and b-blockers less often than men. The unadjusted rates of thrombolysis, angiography and PTCA use were lower in women than men, but not after covariate adjustment. The in-hospital mortality was higher in women than men (11.7% versus 8.1%, odd ratio (OR) 1.51, 95% CI 1.09 to 2.11, p<0.05), but this difference was not significant after adjustment for age (adjusted OR 0.98, 95% CI 0.69 to 1.40, p=NS). CONCLUSION: Women with AMI are less aggressively managed than men, and have higher in-hospital mortalities. The difference in outcome seems to be associated with increased age, with a greater co-morbidity of women.
Angiography ; Female ; Heparin ; Hospital Mortality ; Humans ; Hypertension ; Male ; Mortality ; Myocardial Infarction* ; Prevalence ; Sex Characteristics*

Cholesterol embolism is due to dislodgment of cholesterol crystals from the atheromatous aorta resulting in an occlusion of small arteries. Cholesterol emboli may occur spontaneously but usually develops as a complication of vascular procedures. The organs most frequently involved are the skin and the kidneys but any organ can be affected. Cutaneous manifestations include livedo reticularis, indurated firm violaceous painful plaques and noduli tending to show central necrosis and tender blue toes. We report two cases of cutaneous cholesterol embolization of lower extremities with the impairment of renal function after coronary angiography, proven by skin biopsy.
Aorta ; Arteries ; Biopsy* ; Cholesterol* ; Coronary Angiography* ; Embolism ; Embolism, Cholesterol* ; Kidney ; Livedo Reticularis ; Lower Extremity ; Necrosis ; Skin* ; Toes

Doxylamine is common over-the-counter sleep preparations & frequently involved in overdoses. The clinical course is dominated by the anticholinergic effects, including central nervous system & autonomic effects. We report 4 cases of suicide attempts in adults where ingestion of the doxylamines were complicated by rhabdomyolysis. They ingested doxylamines variable amount & were carried to emergency department. They complained gastrointestinal or central nervous system symptoms. Gastric lavages & administrations of activated charcoal were done. Creatine phosphok inase levels were normal or markedly elevated on arrival, but peaked several days later. Serum creatinine levels were normal. 99mTc-MDP bone scans were showed increased muscle labelling at the regions of muscle injury. They were treated with hydration, urine alkalinization, & supportive measures in hospital. On considering cause of rhabdomyolysis, our patients did not show any evidence of viral illness or coingestion of other potential myopathic toxins to support a secondary cause of rhabdomyolysis. The mechanism of rhabdomyolysis in cases of doxylamine overdose seems to be a direct toxic effect of the drug on striated muscle, but the exact mechanism is not clear. In all cases where such overdoses are suspected, consideration should be given to obtaining a urinalysis & a creatine phosphokinase level on arrival & creatine phosphokinase levels are carefully followed. Primary detoxication included gastric lavage & administration of activated charcoal. The patient's urine output & renal function should be closely monitored.
Adult ; Autonomic Agents ; Central Nervous System ; Charcoal ; Creatine ; Creatine Kinase ; Creatinine ; Doxylamine* ; Eating ; Emergency Service, Hospital ; Gastric Lavage ; Humans ; Muscle, Striated ; Rhabdomyolysis* ; Suicide ; Technetium Tc 99m Medronate ; Urinalysis

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent dermatology pathogens in hospitals and increasingly recognized in communities. We determined PFGE pattern of SmaI-restricted genomic DNA, coagulase type, and antimicrobial susceptibility of MRSA isolated in 2008 from dermatology inpatients and healthy hospital employees in A Hospital and from primary school children in Iksan city, Korea. Overall, the isolation rate of MRSA was 3.8% from the 788 normal persons: 4.9% from hospital employees and 1.1% from primary school children. MRSA was isolated in six of 13 (46.2%) family members of four school children with MRSA. The most prevalent coagulase serotype was II from patients and V from healthy individuals. Ten of twenty and six of twenty MRSA isolates from patients and from healthy personnel, respectively, had identical PFGE patterns, suggesting that these are originated from identical clones. Against MRSA from patients, only vancomycin was the most active (MIC range < or =2 microg/ml), whereas the resistance rates were 35% to rifampin and 65% to mupirocin. The resistance rates of patient isolates were > or =90% to amikacin, clindamycin, ciprofloxacin, erythromycin, fusidic acid, gentamicin and tetracycline. In conclusion, the MRSA carriage rates of healthy hospital workers were relatively high, 2.3~7.7%, depending on groups. Family members of a few primary school children with MRSA showed a high carriage rate, suggesting that intrafamily transmission occurred. MRSAs isolated from dermatology inpatients were relatively more resistant to various antimicrobial agents, including mupirocin, but all isolates were susceptibility to vancomycin.
Amikacin ; Anti-Infective Agents ; Child ; Ciprofloxacin ; Clindamycin ; Clone Cells ; Coagulase ; Dermatology ; DNA ; Erythromycin ; Fusidic Acid ; Genotype ; Gentamicins ; Humans ; Inpatients ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mupirocin ; Rifampin ; Tetracycline ; Vancomycin ; Natural Resources