Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona, Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term 'chronic pulmonary coccidioidomycosis'is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed fianlly by lobectomy and histologic examination.
Arizona ; California ; Coccidioides ; Coccidioidomycosis* ; Cough ; Diagnosis ; Endemic Diseases ; Female ; Humans ; Inhalation ; Lung ; Nevada ; New Mexico ; Pneumonia ; Solitary Pulmonary Nodule*

BACKGROUND/AIMS: Screening for hepatitis B virus (HBV) is recommended in populations with anticipated prevalence > or =2%. This study surveyed HBV screening and vaccination practices of Asian American primary care providers (PCPs). METHODS: Approximately 15,000 PCPs with Asian surnames in the New York, Los Angeles, San Francisco, Houston, and Chicago areas were invited to participate in a web-based survey. Asian American PCPs with > or =25% Asian patients in their practice were eligible. RESULTS: Of 430 (2.9%) survey respondents, 217 completed the survey. Greater than 50% followed > or =200 Asian patients. Although 95% of PCPs claimed to have screened patients for HBV, 41% estimated that < or =25% of their adult Asian patients had ever been screened, and 50% did not routinely screen all Asian patients. In a multivariable analysis, the proportion of Asian patients in the practice, provider geographic origin and the number of liver cancers diagnosed in the preceding 12 months were significantly associated with a higher likelihood of screening for HBV. Over 80% of respondents reported that < or =50% of their adult Asian patients had received the HBV vaccine. CONCLUSIONS: Screening and vaccination for HBV in Asian American patients is inadequate. Measures to improve HBV knowledge and care by primary-care physicians are critically needed.
Adult ; Asian Americans ; Asian Continental Ancestry Group ; Chicago ; Data Collection ; Hepatitis ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Neoplasms ; Los Angeles ; Mass Screening ; New York ; Prevalence ; Primary Health Care ; San Francisco ; Vaccination

Incidence was derived from published data from 2 population-based registries - the Philippine Cancer Society - Manila Cancer Registry and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1,674 square kilometer area that comprises Metro Manila and Rizal province. Thirteen registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and received continuing professional assistance from the International Agency for Research on Cancer (IARC). For the period 1988-1992 the combined age-standardized incidence rate (ASR) was 9.9 per 100,000 for male stomach cancer (ranked fifth, 4.5% of all male cancers), and 5.9 per 100,000 among females (ranked ninth, 2.8% of all female cancers). Stomach cancer among Philippine residents had lower ASRs and age-specific rates compared to Japanese, Korean, Chinese, Singaporean Chinese and Vietnamese populations. Age-specific rates among Filipinos reached 10 per 100,000 or higher at age-group 50-54 years among males, and 55-59 years among females. Significant differences in incidence were observed in only few cities and municipalities. There were little differences in ASRs between 2 populations during 3 time periods between 1980-1992, in both males and females with an indication of a slight decrease. Incidence of male Philippine migrants to Hawaii, San Francisco and Los Angeles were comparable to those of white residents covered by the Manila registry. Among females, stomach cancer incidence of Philippine residents and Filipina migrants to Hawaii were similar, and were slightly higher than those of white residents in Hawaii and both migrants and white residents in San Francisco and Los Angeles

Human ; Male ; Female ; San Francisco ; Los Angeles ; Transients And Migrants ; Stomach Neoplasms ; Hawaii ; Philippines ; Censuses ; Registries ; European Continental Ancestry Group ; Research

STATEMENT OF PROBLEM: Elastomeric impression materials have been widely used to obtain an accurate impression. However there have not been enough studies on the influence of the thickness of the tray adhesives on the bonding strength between the trays and the elastomeric impression materials. PURPOSE: In order to understand the relationship between the thickness of the tray adhesive and the tensile bond strength and to suggest the thickness at which the bonding strength is strongest, tensile bond strength related to the thickness of adhesives of 3 different elastomeric impression materials were tested. MATERIALS AND METHODS: 3 impression materials, Permlastic(R) Regular Set(Kerr Corp., Romulus, Michigan, U.S.A.), Impregum(TM) Penta(TM)(3M ESPE, Seefeld, Germany), and Aquasil Ultra Monophase Regular Set Smart Wetting(R) (Dentsply Caulk, Milford, Delaware, U.S.A.), were used in this study, and tray adhesives from the same manufacturers of the impression materials were used, which were Rubber Base Adhesive, Polyether Adhesive, and Silfix, respectively. The tray specimens were prepared by autopolymerizing the tray material(Instant Tray Mix, Lang, Wheeling, Illinois, U.S.A.), and a PVC pipe was used to house the impression material. In group A, tray adhesives were applied in multiple thin layers of 1 to 5 and in group B, adhesives were applied only once, in the thickness equivalent to several applications. Lightness(L*) of the adhesion surface was measured with a spectrophotometer (CM-3500d, Konica Minolta, Sakai, Osaka, Japan). The tensile bond strength of the elastomeric impression material and the tray resin was measured with universal materials testing machines(Instron, Model 3366, Instron Corp, Nowood, Massachusetts, U.S.A.). A formula between the number of adhesive application layers and the lightness of the adhesion surface was deduced in group A, and the number of adhesive layers in group B was estimated by applying the lightness(L*) to the deduced formula. RESULTS: 1. In group A, a statistically significant increase in tensile bond strength appeared when the number of application layers increased from 1 to 2 and from 4 to 5, and no significant difference was present between 2, 3, and 4 layers in Permlastic. In Impregum, the tensile bond strength was significantly increased when the number of adhesive layers increased from 1 to 3, but no significant difference after 3 layers. In Aquasil, the tensile bond strength significantly increased as the number of application layers increased up to 4 but showed no significant difference between 4 and 5. 2. In group B, the tensile bond strength was decreased when the thickness of the adhesive increased in Permlastic. Impregum showed an increased tensile bond strength when the thickness of the adhesive was increased. In Aquasil, the tensile bond strength increased as the number of adhesive application layers increased up to approximately 2.5 layers but it sharply decreased after approximately 4.5. CONCLUSION: From the study, the common idea that it is better to apply a thin and single coat of tray adhesive needs correction in more detailed ways, and instructions on some of the tray adhesives should be reconsidered since there were several cases in which the tensile bond strength increased according to the increase in the thickness of the adhesives.
Adhesives* ; Delaware ; Elastomers* ; Illinois ; Massachusetts ; Materials Testing ; Michigan ; Rubber

Undifferentiated squamous cell carcinoma, lymphoepithelioma-like carcinoma of salivary glands is rare disease, the incidence of which is highest among the Inunit of Greenland and North America. By the way, the relation of Epstein-Barr virus(EBV) with this tumor has not been studied to any great extent here in Korean because of rare number of cases. Correlations between lymphoepithelioma and EBV have been investigated with morphologic and pathologic evaluation. Recently, nonnasopharyngeal neoplasms, which have morphologic features identical to those lymphoepithelioma, called lymphoepithelioma- like carcinoma(LEC). We experienced the treatment of lymphoepithelioma-like carcinoma arising from the parotid gland and a case is presented with the review of literatures.
Carcinoma, Squamous Cell ; Greenland ; Herpesvirus 4, Human ; Incidence ; North America ; Parotid Gland* ; Rare Diseases ; Salivary Glands

BACKGROUND: Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection. CASE PRESENTATION: Symptoms and findings from 22 workers who were exposed to tetryl are summarized. CONCLUSIONS: This study highlights the health hazards from exposure to tetryl. Occupational health professionals need to maintain vigilance to protect workers from the risks of handling older munitions.
Occupational Health ; West Virginia

This study was conducted to compare the body image perception, weight control experiences and the eating disorders according to where they were born, and the length of residence in USA among Korean-American college students. Three hundred college students participated in the study: 144 males and 156 females, 122 America-born (AB) and 171 Korea-born (KB) who live in New York City and New Jersey. Subjects responded to a self-administered questionnaire. The results showed that the ratio of overweight (23.2%) and obesity (26.8%) of males was higher than females' (16.1% and 6.3%, respectively). There were no significant differences according to born-place or the length of residence in USA of KB. People who had tried to control their weight were 58%. The ratio of weight control experiences of females (72.4%) was higher than males' (42.4%) as well as people who were normal or underweight than who were overweight or obesity. There were no significant differences according to born-place or the length of the residence in the USA of KB. In body image perception, the subjects who were normal and underweight overestimated their body figure, and the subjects who were overweight and obese underestimated their body figure. The desired and ideal figure of female students was significantly thinner than the current figure and also that of male students. There were no significant differences according to born-place or the length of the residence in USA of KB. The ratio of eating disorder was 8.7%, and females had higher percentage than males. And shorter they lived in USA, the percentage of eating disorder was higher.
Asian Americans ; Body Image ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Male ; New Jersey ; New York City ; Obesity ; Overweight ; Surveys and Questionnaires ; Thinness ; Weight Perception

Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.
Canada ; North America ; Prognosis ; Tic Disorders ; Tics* ; Tourette Syndrome*

OBJECTIVES: Geographic Information Systems (GIS) is a powerful tool for assessing exposure in epidemiologic studies. We used GIS to determine the geographic extent of contamination by perfluorooctanoic acid, C8 (PFOA) that was released into the environment from the DuPont Washington Works Facility located in Parkersburg, West Virginia. METHODS: Paper maps of pipe distribution networks were provided by six local public water districts participating in the community cross-sectional survey, the C8 Health Project. Residential histories were also collected in the survey and geocoded. We integrated the pipe networks and geocoded addresses to determine which addresses were serviced by one of the participating water districts. The GIS-based water district assignment was then compared to the participants' self-reported source of public drinking water. RESULTS: There were a total of 151,871 addresses provided by the 48,800 participants of the C8 Health Project that consented to geocoding. We were able to successfully geocode 139,067 (91.6%) addresses, and of these, 118,209 (85.0%) self-reported water sources were confirmed using the GIS-based method of water district assignment. Furthermore, the GIS-based method corrected 20,858 (15.0%) self-reported public drinking water sources. Over half (54%) the participants in the lowest GIS-based exposure group self-reported being in a higher exposed water district. CONCLUSIONS: Not only were we able to correct erroneous self-reported water sources, we were also able to assign water districts to participants with unknown sources. Without the GIS-based method, the reliance on only self-reported data would have resulted in exposure misclassification.
Cross-Sectional Studies ; Drinking Water* ; Drinking* ; Epidemiologic Studies ; Geographic Information Systems* ; Geographic Mapping ; Methods ; Washington ; Water ; West Virginia

The practice of outpatient breast cancer surgery has been controversial in the United States. This study aimed to update time trends and geographic variation in outpatient breast cancer surgery among elderly Medicare fee-for-service women in the United States. Using the 1993-2002 linked Surveillance, Epidemiology and End Results (SEER)-Medicare claims data and the Area Resource Files, we identified 2 study samples, including the women whose breast cancers were the first-ever-diagnosed cancer at age 65 years or older from 9 regions continuously covered by the SEER registries since 1993. The first sample included the women receiving unilateral mastectomy for stage 0-IV cancer; the second included the women receiving the breast-conserving surgery with lymph node dissection (BCS/LND) for stage 0-II cancer. The proportions of patients receiving outpatient surgery increased from 3.2% to 19.4% for mastectomy and from 48.9% to 77.8% for BCS/LND from 1993 to 2002. We observed substantial geographic variation in the average proportion of the patients receiving outpatient surgery in the studied areas across the 10-year period, ranging from 3.9% in Connecticut to 27.2% in Utah for mastectomy and from 54.7% in Hawaii to 78.1% in Seattle, Washington, for BCS/LND. As the popularity of outpatient breast cancer surgery continues to grow, more evidence-based analyses related to quality and outcomes of outpatient breast cancer surgery among various populations are needed in order to facilitate the public debates about state and federal mandated health benefit legislations.
Aged ; Ambulatory Surgical Procedures ; statistics & numerical data ; trends ; Breast Neoplasms ; pathology ; surgery ; Connecticut ; Fee-for-Service Plans ; statistics & numerical data ; Female ; Hawaii ; Humans ; Lymph Node Excision ; statistics & numerical data ; Mastectomy ; statistics & numerical data ; Mastectomy, Segmental ; statistics & numerical data ; Medicare ; Neoplasm Staging ; SEER Program ; United States ; Utah ; Washington