We report a patient who developed a Barrett,s esophageal ulcer 10 years after esophagomyotomy for achalasia. A-59-year-old female was admitted to the hospital with dysphagia for 2 months. In 1982, she had undergone a modified Heller esophagomyotomy for achalsia. After esophagogram, esophageal manometry, 24hr esophageal pH monitoring, esophagoscophy achalasia and Barrett,s esophageal ulcer was diagnosed. So, she had been treated with omeprazole and sucralfate and has been followed up in a asymtomatic state currently. In Barrett,s esophagus, there is a metaplasia of the normal stratified squamous mucosa to columnar epithelium, caused by the reflux of acid. It appears in approximately 10% of patients with chronic gastroesophageal reflux and is associated with increased probability of adenocarcinoma of the esophagus. Among the predis- posing factors of gastroesophageal reflux, there is treatment of esophageal achalsia by forceful dilatation or by the esophagomyotomy. The resultant ralaxation of lower esophageal sphinter, combined with deficient propulsive esophageal peristalsis, predisposed to gastroesophageal reflux. Actually an increased incidence of gastroesophageal reflux, esophagitis and stricture are well-known complications after esophagomyotomy. But in spite of higher risk of gastroesophageal reflux after esophagomyotomy the development of Barrett,s mucosa has been rarely reported and only recently recognized. Diagnosis of Barrett,s esophagus in such patients is difficult and the cumulative effects of achalasia and Barrett's esophagus predispose these patient to higher risk of developing esophageal carcinoma. So, high index of awareness and regular endoscopic surveillance are required.
Adenocarcinoma ; Barrett Esophagus ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Dilatation ; Epithelium ; Esophageal Achalasia* ; Esophageal pH Monitoring ; Esophagitis ; Esophagus ; Female ; Gastroesophageal Reflux ; Humans ; Incidence ; Manometry ; Metaplasia ; Mucous Membrane ; Omeprazole ; Peristalsis ; Sucralfate ; Ulcer*

A 26-year-old man with a one-year history of asthma and sinusitis presented with bilateral pleural effusions, patch basilar infiltrates on a chest x-ray and a pericardial effusion on an echocardiogram. The peripheral blood showed marked eosinophilia. An obstructive pattern was also observed during the pulmonary fuction test, which was responsive to bronchodilator inhalation. Nerve conduction studies showed right sural neuropathy. Thoracentesis yielded an acidotic exudative effusion with low glucose, low C3 and eosinophilia. An open lung biopsy revealed an eosinophilic interstitial pneumonitis associated with a necrotizing eosinophilic vasculitis, and granulomatous inflammation foci. In the literature, pleural effusions were reported in 29 percent of Churg-Strauss patients, but the number of effusions was low and their characteristics have not been well described. This report describes the characteristic findings of pleural fluid and its histologic features in a case of classical Churg-Strauss syndrome.
Adult ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Glucose ; Humans ; Inflammation ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Neural Conduction ; Pericardial Effusion ; Pleural Effusion* ; Sinusitis ; Thorax ; Vasculitis

Cubitus varus deformity is the late complication of the supracondylar fracture of humerus which is common in growing children. If the deformity is severe it causes tunctional problems as well as cosmetic ones necessitating conective osteotomy. Though many authors devised different methods of corrective osteotomy, the cosmetic results are not always satisfactory because of the development of the lazy S deformity hy the lateral prominence. Technically. the initial stahility of the osteotomy is also poor due to the poor contact of the osteotomy site. So we have devised a new quadrilateral displacement osteotomy to increase the initial stability of the osteotomy by creating a wedge on the osteotomy site & also to prevent the development of the lazy S deformity hy elimination of the Interal prominence. We treated 9 cases of cubitus varus deformity with the new quadrilateral displacement osteotomy. The correction technique was not difficult & the initial stahility of the osteotomy is rather good & the osteotomy is fixed by the conventional methods, & all of the cases were healed uneventfully. There developed no the lazy & deformity after osteotomy. We would like to report the details ot the supracondylnrquadrilateral displacemenl osteotomy.
Child ; Congenital Abnormalities* ; Humans ; Humerus ; Osteotomy*

Purpose: The purpose of this study was to understand the experiences of mothers of infants who received sustained nurse home visiting services. The program of sustained home visit by nurses (Seoul Maternal Early Childhood Sustained Home-Visiting Program) is an intervention program. Its effectiveness has been verified in Australia, where services are provided to families in a vulnerable families during the period from prenatal period until the newborn is 2 years old. Methods: The study protocol used qualitative approaches. Eleven mothers of infants who received nursing services in December 2015 were invited for an in-depth interview. The data collected were subjected to directed content analysis. Results: The following 4 themes were identified from the analysis: (1) reduction in suspicion and increased feeling of benefit from the visiting service, (2) emotional support to the parents and use of community resources, (3) reliance on friendly nurses, and (4) gaining confidence about parenting and motherhood. Conclusion Sustained nursing home visiting services can be applied effectively in South Korea. The concrete narrations and descriptions of the experiences of mothers in this study can be used as a base for education, practice, and research.

Lactococcus garvieae is a Gram-positive cocci that has been known to be a fish pathogen, and considered as a low virulence organism rarely associated with human infection. We report a case of acute cholangitis with common bile duct (CBD) stone and bacteremia by L. garvieae bacteremia in a 70-year-old male. The patient presented with epigastric pain and was diagnosed with two CBD stones. Blood culture obtained prior to empiric antimicrobial therapy with ceftizoxime sodium showed growth with Escherichia coli and L. garvieae. The bacteria were confirmed by matrix-assisted desorption/ionization time-of-flight mass spectrometry. Initial attempt at endoscopic biliary drainage failed, and the patient underwent percutaneous transhepatic biliary drainage and subsequent stone removal. He occasionally ingested raw fish and had a history of gastric ulcer with acid suppression therapy, which could be possible risk factors for L. garvieae infection. This is the first case of L. garvieae bacteremia in acute cholangitis.

This study was conducted to evaluate the eating behavior and to analyze the various factors affecting eating behavior among middle school students. The subjents consisted of 212 middle school students(106 boys and 106 girls between 13-14 years) residing in Seoul. A questionnaire was used as the questionnaire consisted of four parts : the socio-demographic characteristics of the subjects, value toward food and nutrition, diet diversity(the number of food items) and eating behavior. Results showed that fifty three point five percent of males and fifty seven percent of females skipped breakfast. The main reason for skipping breakfast was shortage of time. Fifty five percent of the total number of subjects stated that they had more than two plasant meals a day. The number of food items eaten was significantly higher in males than in females. In only 16.4% of total subjects(18.5% of male and 14.2% of female), the primary pursuit in having meals was not to satisfy hunger but to consider nutrition and health. The eating behavior of the adolescents showed that 65% of the subjects had a 'good' eating behavior score and 17.4% had scores of 'excellent' and 'poor' respectively. The existence of parents, the economic level of the family, and concern of health and nutrition affected the eating behavior score. The less the subject skipped breakfast, the greater they placed a value toward food and nutrition. Value toward food and nutrition had a significant influence on their eating behavior. Those who placed a value toward food and nutrition had a higher eating behavior. Those who placed a value toward food and nutrition had a higher eating eating behavior. As a result of the multiple regression analysis, factors affecting eating behavior were 'pleasant meal' , 'the value toward food and nutrition' and 'the numbers of food items' in order(R2=0.2984).
Adolescent ; Breakfast ; Diet ; Eating* ; Feeding Behavior* ; Female ; Humans ; Hunger ; Male ; Meals ; Parents ; Seoul* ; Surveys and Questionnaires

OBJECTIVES: This study was performed to investigate the nutritional status, health conditions, eating habits and experience and demand for nutrition.dietary management of senior citizens. And these data are formed foundation of development of nutrition.dietary management education program and contents in welfare facilities for the aged. METHODS: We visited 3 public health centers, 3 senior citizens centers, and 4 welfare centers in Seoul, Gyeonggi-do, Chungnam province, and Daejeon area and carried out interview by semi-structured questionnaire for senior citizens older than 65 years who use those facilities. RESULTS: The study included 17%, 30.7% and 52.3% of senior citizens from public health centers, seniorcitizen centers and and welfare centers, respectively. The age range of 43.9% of the population was 65-74 years and and 56.1% were older than 75 years. We observed that 83.2% of subjects took some medicines due to diseases that they have and 58.0% took prescription medicines for hypertension. The thing that they considered the most when selecting food was 'the taste'(p<0.05). Regarding the level of practice to keep the dietary life, they answered more than 'average' for most of items but answered less than 'average' for lot of salt intake, drinking, exercise. For the experience of nutritionddietary life education, only 19.8% answered 'Yes' and the service for nutritionddietary life management showed the highest score in the demand for 'provide nutritious food'. For the size of consulting group for nutrition/dietary life education, the public health center and welfare center preferred a larger group size but the senior citizens center preferred a smaller group. With regard to who will carry out the consulting, the demand for dietitian was the highest and the operation type showed the high demand in the order of consulting, education. The contents that they want to have consultation in nutritionddietary life education were diet therapy for diseases and the ordinary diet therapy for health. CONCLUSIONS: This study suggested the management of nutritionddietry life necessitates qualitative measures according to the different types of welfare facilities. For these, it is in need of development of counseling and education program included therapy for disease. Above all, the policy to secure dietitian of welfare facilities for the aged to perform these should be achived.
Aged* ; Chungcheongnam-do ; Counseling ; Diet Therapy ; Drinking ; Eating ; Education ; Gyeonggi-do ; Humans ; Hypertension ; Nutritional Status ; Nutritionists ; Prescriptions ; Public Health ; Seoul

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of conventional transurethral resection of the prostate (TUR-P), transurethral resection in saline (TURIS), and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19), or TURIS-V (15) for BPH were retrospectively analyzed. All procedures were carried out by a single surgeon between October 2007 and April 2010. The patients were assessed preoperatively and perioperatively and were followed at 1, 3, and 6 months postoperatively. Patient baseline characteristics, perioperative data, and postoperative outcomes were compared, and major complications were recorded. RESULTS: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (p=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration, and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between the groups in hemoglobin levels or serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications. CONCLUSIONS: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was not inferior to conventional TUR-P or TURIS in terms of safety.
Catheters ; Follow-Up Studies ; Hemoglobins ; Humans ; Length of Stay ; Male ; Pilot Projects ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Retention (Psychology) ; Retrospective Studies ; Sodium ; Transurethral Resection of Prostate ; Urologic Surgical Procedures ; Volatilization

This study estimated the isoflavone intake level in Koreans using Food Frequency Questionnaire and analyzed related variables. The results showed that the average daily intake of isoflavone in adults was shown as 23.1 mg. The isoflavone intake level at 50 percentile was 16.9 mg (0~190 mg), and 10% of adults took almost 50 mg of isoflavone a day and 10% took about 5 mg a day. The major food sources for isoflavone in Koreans were in the order of soybean, soybean paste, soy milk, soybean curd (tofu), and bean sprouts; the intake was different depending on age, educational background, occupation, economic standard, and family type. The result showed higher isoflavone intake levels in the group over 30 years old and the highest isoflavone intake in subjects working in farming/fishery, followed by housemakers. According to the differences by families the families with elderly members showed 50% higher isoflavone intake than young families with friends or siblings. Depending on related ecological variables, therefore, various nutrition education programs should be developed for a variety of intakes of soybean foods, along with easy and simple cooking methods as parts of continuous research.
Adult* ; Aged ; Cooking ; Education ; Friends ; Genistein ; Humans ; Occupations ; Surveys and Questionnaires ; Siblings ; Soy Foods ; Soy Milk ; Soybeans

This study analyzed Kimchi eating culture in 178 households with female middle school children located in Incheon and Seosan areas, investigated the Kimchi eating patterns of female middle school students, and also analyzed the differences in value recognition for Kimchi between mothers and their female middle school students. Results showed that 23.0% of subject households answered eat Kimchi at every meal and the main reason for eating Kimchi in most households was good for taste. Most households made their own Kimchi, and only 12.3% of households bought Kimchi. Subject households preferred hot and spicy taste (34.8%) and pleasing taste (20.2%), and 44.4% of middle school children answered as eating Kimchi at every meal, and the source for information on Kimchi was home in 51.6% and mass media in 33.7%, suggesting the lack of school education. Both mothers and their female middle school students placed high value on Kimchi for its nutritional aspect and on Kimchi from the market for its convenience. Mothers showed significantly higher value (p<0.05) on the storage aspect of Kimchi compared to their middle school students, and female middle school students showed significantly higher value (p<0.05) on the value recognition for Kimchi as an international food compared to their mothers. Also, the value for hot pepper powder was high among other additional ingredients, and both mothers and middle school students had high values for Kimchi stew among other food dishes using Kimchi, and middle school students showed higher values (p<0.001) on foreign dishes using Kimchi such as Kimchi pizza and Kimchi spaghetti compared to the mothers group. Therefore, based on these results, the development of educational programs on Kimchi is needed not only at home but also at schools, by re-emphasizing the importance of value recognition for KImchi in our food culture.
Child ; Chungcheongnam-do ; Eating* ; Education ; Family Characteristics ; Female* ; Humans ; Incheon ; Mass Media ; Meals ; Mothers*