An epidemiologic investigation was conducted to identify the source of infection and the mode of transmission of typhoid fever outbreak occurred in Ohchun middle and high schools located in Young il Gun, Kyungpook Province from May 21 to Jun 4, 1994. Four out of 13 hospitalized students in three general hospitals in Pohang City were culture positive typhoid fever (Salmonella typhi Group D). Review of the in and outpatient logbooks of the three general hospitals in Pohang City, county health center and local clinics in the vicinity of the Ohchun middle and high schools suggested that the outbreak was confined to the schools. Drinking water source of the schools was two underground water pumps that had no treatment facilities; one in northern end and the other in southern end of the main school building. However, the southern water pump was closed on April 28, 1994 because a recent test for the water revealed E-coli suggesting a possible fecal contamination. Two hundred twenty students stated that they had experienced symptoms related to typhoid fever since April l, 1994 in a self administered questionaire survey of all of the 2, 226 students. Personal interviews with these 220 students were performed to confirm the clinical history together with a rectal swab culture for typhoid fever and Widal test. A total of 39 patients were detected; 15 confirmed cases (culture-positive) and 24 suspected cases (symptom positive with equal to or greater than 1:160 titer of Salmonella O-antibody or 1:320 titer of H-antibody titer in Widal test). The epidemic curve showed a unimodal curve with a peak on the second week(17 May, 1994) and tailed down to the 5th week (22 28 May, 1994). The overall incidence rate of typhoid fever was 1.8 per 100 students; 1.5 (1.6 for male, 1.5 for female) in the middle school and 2. 4 (6. 2 for male, 0. 4 for female) in the high school. When contrasted with the students who did not drink water at all in the school, the relative risks of incidence rate of typhoid fever for the students who drank the underground water of the school, both underground water and water brought from home, or water brought from home only were 55.5, 19.0, and 3.0 respectively. Three classes which had especially high incidence rates of typhoid fever were located in the southern part of the main school building, where the contaminated underground water pump is located. These findings suggested that the source of infection was the contaminated underground water of the school. Both of the two underground water pumps were closed permanently and the public running water was supplied to the schools.
Drinking Water ; Groundwater ; Gyeongsangbuk-do* ; Hospitals, General ; Humans ; Incidence ; Male ; Outpatients ; Running ; Salmonella ; Typhoid Fever* ; Water

OBJECTIVES: The purpose of this study was to assess the clinical and polysomnographic characteristics of Korean patients with obstructive sleep apnea syndrome (OSAS), especially in relation to differences due to age and gender. METHODS: All subjects were consecutive patients who were proven to have OSAS with nocturnal polysomnography. They were interviewed with a structured interview format including sociodemographic information, past medical history, medication, and sleep-related history. Simultaneously, they were also given Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to answer in order to check subjective sleep quality and subjective sleepiness. RESULTS: Mean age of the 308 subjects was 49.5+/-13.3 years, with 77.6% of the subjects being males and 22.4% of the subjects being females. The aging effects on the sleep architecture in Korean OSAS corresponded with normal aging, but with the effect of OSAS itself superimposed, the extent of aging effects was more marked than that of normal aging. The severity of Korean patients of OSAS was not correlated with age. When divided into age subgroups, significant correlation was found between RDI and BMI in patients of each subgroup of those in the 4th to 7th decades. The oldest subgroup (>70 years) described their subjective sleep quality as poorer than any other age subgroups, despite of less subjective drowsiness. The severity of OSAS and the change of sleep architecture of male subjects turned out to be severer than those of female ones. The female/male ratio of the subjects tended to increase with aging. CONCLUSIONS: The aging effect on the sleep architecture in Korean OSAS seems to be a mixture of the changes by normal aging and sleep disorder per se. The severity of OSAS was not correlated with age, but highly correlated with BMI. The severity of OSAS and the change of sleep architecture of male patients were severer than those of female ones.
Aging ; Body Mass Index ; Female ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; Sleep Stages

Color developers(CD) have been noted to produce lichen planus like eruption as well as eczematous contact dermatitis. The chemicals involved are derivatives of paraphenylenediamine or aniline, i. e., Kodak CD 2, Kodak CD 3, Agfa TSS. We report a 28-year-old male who showed a feature of lichenoid contact dermatitis after exposure to color developer. Patch test revealed positive reactions to CD2, CD3 and CD4. Skin biopsy from a patch site showed lichen planus-like tissue reaction.
Adult ; Biopsy ; Dermatitis ; Dermatitis, Contact* ; Humans ; Lichen Planus ; Lichens ; Male ; Patch Tests ; Skin

PURPOSE: Exercise-induced bronchospasm (EIB) is widely prevalent in asthmatic patients. Recently, eosinophilic airway inflammation and atopy (defined as skin sensitivity to common aeroallergens) are considered to be a important factors in the pathogenesis of asthma. Thus we studied to find out the effect of atopy and airway eosinophilic inflammation on exercise- induced bronchospasm. METHODS: We followed up the cases of 132 mild asthmatics for 2 years. On their first visit, skin prick tests, with 29 common allergens including dust mites antigen, and sputum induction were performed. And 3 days later, methacholine challenge was done. 24 hours after methacholine challenge, treadmill test was performed and the positive EIB was defined as a 15% reduction or more in FEV1 from baseline after exercise. RESULTS: EIB was observed in 54 (40.9%) of 132 asthmatic subjects. There was no significant difference in atopy between EIB positive and EIB negative asthmatics. Eosinophil and eosinophil cationic protein in induced sputum were significantly higher in EIB positive asthmatics. We also found the significant correlation between bronchial responsiveness (BR) index and maximal % fall in FEV1. CONCLUSION: The severity of bronchospasm evoked by exercise was more closely related to eosinophilic airway inflammation and airway hyperresponsiveness to methacholine than atopy.
Allergens ; Asthma ; Asthma, Exercise-Induced* ; Bronchial Spasm ; Dust ; Eosinophil Cationic Protein ; Eosinophils* ; Exercise Test ; Humans ; Inflammation* ; Methacholine Chloride ; Mites ; Skin ; Sputum

OBJECTIVES: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. METHODS: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA DQB1 *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. RESULTS: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward) (t=3.86, p< 0.01; t=-2.47, p=0.02; t=-3.95, p< 0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. CONCLUSION: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.
Alleles ; California ; Cataplexy ; Cognition ; Executive Function ; Humans ; Memory ; Memory, Short-Term ; Motor Activity ; Narcolepsy* ; Neuropsychological Tests ; Polysomnography ; Stroop Test ; Trail Making Test ; Verbal Learning ; Wisconsin

No abstract available.
Carcinoma, Squamous Cell* ; Colon* ; Colonic Polyps* ; Female* ; Humans ; Urethra*

PURPOSE: Airway eosinophilic inflammation is a characteristic feature of asthma. Sputum analysis can be used as a non-invasive tool to assess severity of the airway inflammation. This study was performed to compare relationships between sputum eosinophils to other parameters of airway inflammation and to evaluate the clinical utility of sputum eosinophils and ECP in childhood asthma. METHODS: A total of 40 asthmatic children over 6 years of age were divided into two groups : Group A of 15 current symptomatic subjects and Group B of 25 stable asymptomatic subjects with history of asthma for 2 weeks. Eosinophils in induced sputum were compared with the severity of asthma symptom, pulmonary function, bronchial hyperresponsiveness by methacholine, sputum ECP, blood eosinophils and serum ECP. RESULTS: 1) Asthmatics had a significantly higher proportion of sputum eosinophils than the control subjects (15.2+/-17.8% VS 3.8+/-4.5%, P<0.01). Group A had a significantly higher proportion of sputum eosinophils than group B (22.9+/-21.7% VS 11.2+/-14.8%, P<0.05). 2) Sputum eosinophils were correlated with symptom scores in asthmatics (r=0.76, P<0.01), inversely correlated with FEV1 in group A (r=-0.65, P<0.01) and with LogPC20 in group B (r=-0.45, P<0.05). 3) Sputum eosinophils were correlated with sputum ECP for group A; r=0.77 (P<0.01) and for group B; r=0.39 (P<0.05) but not correlated with serum ECP. 4) Sputum eosinophils were correlated with blood eosinophils in group A (r=0.67, P<0.05), but not in group B. CONCLUSION: This study suggests that the proportion of eosinophils and the level of ECP in induced sputum may be sensitive and accurate means of assessing the airway inflammation in childhood asthma, and their relationships with blood eosinophils or serum ECP are to be studied further.
Asthma* ; Child ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Sputum*

PURPOSE: We evaluated the diagnostic accuracy and clinical usefulness of fluoroscopy-guided bone biopsy. MATERIALS AND METHODS: A total of 31 patients with various skeletal lesions underwent fluoroscopy-guided bone biopsies. The targets were long bones in 16 cases, pelvic bones in 7 cases, spines in 6 cases, and ribs in the rest 2 cases. RESULTS: The overall accuracy was 71%(22/31). The accuracy was 100% in case of primary sarcoma and multiple myeloma. But it was low in malignant lymphoma(1/4), malignant fibrous histiocytoma(0/1), and nonossifying fibroma(0/1). CONCLUSION: Percutaneous fluoroscopy-guided bone biopsy is a simple, safe, not-expensive, and rather accurate diagnostic procedure in evaluation of bone tumors. In addition to that, it is useful in the managment planning and fllow-up of the patients.
Biopsy* ; Humans ; Multiple Myeloma ; Pelvic Bones ; Ribs ; Sarcoma ; Spine

The present study was performed to determine the optimal time for orchiopexy and seek further understanding of the pathophysiology of infertility as a complication of unilateral cryptorchidism. Testicular tissues for light and electron microscopic examination were biopsied from not only cryptorchid but also contralateral scrotal testes of 28 patients with unilateral cryptorchidism, aged 1 to 24 years. The most considerable findings were as follows; 1. Mean tubular diameter of cryptorchid and contralateral scrotal testes was markedly increased from the age of 13 years. The mean tubular diameter of cryptorchid testes was shorter than that of contralateral scrotal testes. 2. Average cell population in tubule of cryptorchid testes remained at low level compared to contralateral scrotal testes, especially a marked decrease after the age of 13 years. Mean spermatogonia count per tubule of cryptorchid testes was lower than that of contralateral scrotal testes. During the puberty, mean spermatogonia count per tubule of scrotal testes was higher than that of cryptorchid testes and this difference was statistically significant (p<0.05). 3. Basement membrane of both cryptorchid and contralateral scrotal testes became markedly thickened from the age of 13 years and basement membrane of cryptorchid testes was thicker than that of scrotal testes. 4. As the pattern of spermatogenesis, the cryptorchid testes showed germ cell hypoplasia and scrotal testes showed incomplete spermatogenic arrest from the age of 13 years. 5. Leydig cell in interstitium was observed in both cryptorchid and contralateral scrotal testes from the age of 13 years and the number of Leydig cell in the cryptorchid testes was lower than that in the scrotal testes. 6. In ultrastructural study, the decrease in number of mitochondria and ribosomes of rough endoplasmic reliculum of the germ cell and Sertoli cell of cryptorchid testes became evident primarily after 5 years of life compared to those of contralateral scrotal testes. In conclusion, the implications of above finding was to urge surgical correction of unilateral cryptorchid testes before 5 years of life.
Adolescent ; Basement Membrane ; Cryptorchidism* ; Germ Cells ; Humans ; Infertility ; Male ; Mitochondria ; Orchiopexy ; Puberty ; Ribosomes ; Seminiferous Tubules* ; Spermatogenesis ; Spermatogonia ; Testis

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Clinical Study ; Diagnosis ; Lung* ; Neoplasm Metastasis ; Technetium Tc 99m Disofenin