The purpose of this study were to assess iron status and obesity in 82 middle aged women living in Kangnung area. Anthropometric measurements were taken for body weight, height, percentage of body fat and circumferences of waist and hip. Venous blood samples were drawn from subjects for measurement of hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC), transferrin saturation(TS) and serum ferritin. Dietary intakes of iron(heme iron and nonheme iron), the amounts of MPF(meat, poultry and fish) and ascorbic acid were assessed by modified 24-hr recall method. The results obtained are summarized as follows : Postmenopausal women had more body fat than premenopausal women. That is, postmenopausal women tend to be obeser than premenopausal women. There was no difference in Hb, Hct, Fe, TIBC and TS between pre- and postmenopausal women. But the serum ferritin concentration of postmenopausal women(83.7+/-2.1ng/ml) was significantly (p<0.05) higher than premenopausal women(56.4+/-1.0ng/ml). Prevalences of iron deficiency (20%, 20.0% and 17.1% respectively) of postmenopausal women. The mean daily intakes of total iron in pre- and postmenopausal women were 17.5+/-.3mg and 15.6+/-.9mg, respectively. Bioavailabilities of dietary iron were 6.5% and 4.5% in pre- and post-groups. These results indicate that individual dietary guidelines should be used to educate middle-aged women different in status of menopause. For example, premenopausal women should increase nutritional iron status and postmenopausal women should try to prevent obesity.
Adipose Tissue ; Ascorbic Acid ; Biological Availability ; Body Weight ; Female ; Ferritins ; Hip ; Humans ; Iron* ; Iron, Dietary ; Menopause ; Middle Aged ; Nutrition Policy ; Obesity ; Postmenopause* ; Poultry ; Prevalence ; Transferrin

This study was designed to assess the iron nutritional status of girls at puberty in Kangnung area. The subjects consisted of 161 adolescents in sixth-grade in primary school and first-grade in middle school girls. Anthropometric measurements were taken for body weight, height, percentage of body fat, and circumferences of waist and hip. Nutrient intakes were assessed by modified 24-hour recall method. Food models and other measuring tools were also used. Fasting blood samples were obtained and analyzed for hemoglobin(Hb) concentration, hematocrit(Hct), serum iron(FE) and total iron binding capacity(TIBC). Mean values for Hb, Hct, Fe, TIBC, TS and serum ferritin were 13.6+/-0.9g/dl, 39.6+/-3.9%, 91.3+/-36.3 microgram/dl, 327.9+/-45.2 microgram/dl, 28.3+/-11.8% and 37.4+/-24.2ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 4.8% when judged by Hb to 18.4% by serum Fe concentration. The Hb concentration was positively correlated with Hct(r=0.641), serum iron(r=0.266) and transferrin saturation(r=0.237)(p<0.05). On the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.572). Mean daily intake of iron was 14.94mg and heme iron intake was 1.13mg and which was 7.6% of total iron intake. Total absorbable iron calculated by the method of Mosen was 1.38mg and bioavailability of diectary iron was 9.3%. These results suggest that the prevalence of iron deficiency of pubertal girls is very high, therefore the guidelines for diet and social supports, such as, school food service system should be provided to improve their iron status in middle school students.
Adipose Tissue ; Adolescent ; Biological Availability ; Body Weight ; Diet ; Fasting ; Female* ; Ferritins ; Food Services ; Hand ; Hematocrit ; Heme ; Hip ; Humans ; Iron* ; Nutritional Status* ; Prevalence ; Puberty* ; Transferrin

OBJECTIVE: The purpose of this reports is to describe the influence of continuous external ventricular drainage (EVD) on delayed ischemic neurologic deficit (DIND) after early surgery in ruptured aneurysmal patients. METHODS: The authors reviewed 229 patients with aneurysmal subarachnoid hemorrhage (SAH) who had been treated with clipping at a single institution between 1998 and 2004. Of these, 121 patients underwent continuous EVD (Group A) postoperatively, whereas 108 patients did not (Group B). EVD was performed at ipsilateral Kocher's point and maintained 2 to 14 days postoperatively. RESULTS: DIND occurred in 15.7% (19 cases) of patients in Group A, 25% (27 cases) from Group B (P value=0.112). Compared with Group A, Group B was more likely to suffer acute symptom of DIND and showed poor response to 3- H therapy. Major symptoms of DIND in Group A were mild confusion (36.8%) and mild deterioration of mental state (26.3%), contrary to weakness of extremities (59.2%) in Group B. At discharge, Glasgow Outcome Scales (GOS) of Group A were: good recovery (63.2%), moderately disabled (21%), severely disabled (10.5%), dead (5.3%) and Group B : good recovery (48.1%), moderately disabled (37%), severely disabled (14.8%) and dead (0%). Of 121 patients from group A, 35 patients (28.9%) suffered ventriculitis. CONCLUSION: Continuous EVD after aneurysmal clipping in patients with SAH reduced the risk of DIND and its sequelae, relieved its symptoms, and improved the outcome.
Aneurysm* ; Aneurysm, Ruptured ; Drainage* ; Extremities ; Humans ; Neurologic Manifestations* ; Subarachnoid Hemorrhage* ; Ventriculostomy ; Weights and Measures

Intramural esophageal dissection (IED) is a rare form of esophageal injury. We report a rare case of spontaneous IED complicated with pneumomediastinum and successfully improved by conservative management. A 46-year-old man presented to the emergency department with chest pain and hematemesis. The endoscopic diagnosis was suspicious of IED. Chest CT scan performed to rule out complication noted IED combined with pneumomediastinum. He was managed conservatively with nil per oral, intravenous antibiotics and parenteral nutrition. Follow up study after 2 weeks later showed near complete resolution of IED. IED should be included in the differential diagnosis for unexplained acute chest pain, especially, associated with dysphagia and hematemesis. IED with pneumomediastinum or mediastinitis require prompt surgery. So far, there is no case report of IED combined with pneumomediastinum which resolved without surgical treatment. In this case, IED combined with pneumomediastinum has improved by conservative management, so we present a case report.
Anti-Bacterial Agents/therapeutic use ; Esophageal Diseases/complications/*diagnosis/drug therapy ; Gastroscopy ; Hematemesis/complications/diagnosis ; Humans ; Male ; Mediastinal Emphysema/complications/*diagnosis/drug therapy ; Middle Aged ; Tomography, X-Ray Computed

PURPOSE: To determine the diagnostic usefulness of MRI in pulmonary hamartoma, and the significant MRI features other than fat or characteristic calcification, both revealed by CT. MATERIALS AND METHODS: We prospectively studied chest MR images in five patients with pulmonary hamartoma. All underwent narrow-collimated CT scanning and conventional MRI, specimen MRI was available in three cases. Pulmonary nodular size, shape and margin and the presence of intratumoral fat density, calcification and a cleft-like structure were determined. At MRI, the presence and signal intensity (SI) of the cleft-like structure, including intratumoral cystic space and SI of the main portion of the tumor, were analyzed and compared with the findings of specimen MRI, and correlated with the histopathologic findings. In three cases, the typical enhancement pattern revealed by post-contrast MRI was also evaluated. RESULTS: Narrow-collimated CT scanning revealed fat density or popcorn-shape calcification in two cases and a cleft-like structure in one. The other two cases showed neither fat nor calcification. At MRI, however, all five cases showed a cleft-like structure, which was especially evident on T2WI. The detectability of this did not vary between conventional and specimen MRI. The cleft-like structure showed varying SI on T1, and T2WI correlated to variable mesenchymal component including with respiratory epithelial cells lining the cleft. Marginal rim enhancement was noted on all three post-contrast MR images, and correlated with the relatively rich vascularity of the tumor's marginal portion. An enhanced cleft-like structure was noted in two cases. CONCLUSION: The presence of a cleft-like structure, especially prominent on T2WI and with variable SI, is a useful MR finding for the diagnosis of pulmonary hamartoma, and marginal rim enhancement is an ancillary diagnostic MR finding. In particular, MRI is a useful diagnostic tool in cases where a simple pulmonary nodule demonstrates neither fat nor calcification.
Diagnosis ; Epithelial Cells ; Hamartoma* ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging* ; Prospective Studies ; Thorax ; Tomography, X-Ray Computed

The duodenum is the second most common site, after the colon, of diverticuli in the alimentary tract. Although most patients with duodenal diverticuli are asymptomatic, previous studies have demonstrated a possible association between duodenal diverticuli and choledocholithiasis and pancreatitis. In addition, duodenal diverticuli mimicking periampullary tumors and cystic neoplasms of the pancreas have been reported. We report a case of a duodenal diverticulum that mimicked a peripancreatic abscess. A 65-year-old woman was admitted for epigastric pain and vomiting. Abdominal CT confirmed the diagnosis of acute pancreatitis. Follow-up abdominal CT performed for a sustained fever revealed several newly developed peripancreatic abscesses. Most of the abscesses were drained percutaneously, but those around the uncinate process seldom respond to treatment. This patient was confirmed to have a duodenal diverticulum by endoscopy and duodenography. Duodenal diverticuli must be considered in a differential diagnosis of peripancreatic abscesses.
Abscess ; Choledocholithiasis ; Colon ; Diagnosis, Differential ; Diverticulum ; Duodenum ; Endoscopy ; Female ; Fever ; Follow-Up Studies ; Humans ; Pancreas ; Pancreatitis ; Vomiting

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

BACKGROUND: It is important to know one's own exact blood type. While the primary purpose of blood donation is an adequate blood supply, it is also an excellent opportunity for donors to confirm their blood type. Over 5% of the total population in Korea donated bloods in 1997. This study was carried out to investigate the relationship between increased participation in blood drives and an increase in members of the public's knowledge of their own blood type. METHODS: 271,346 blood donors at Dung-Bu Red Cross Blood Center answered to a questionnaire. The discrepancy ratio between perceived and actual ABO blood type was obtained through answerey questionnaire. Another 3,058 answered a more detailed questionnaire to probe their general knowledge of ABO and Rh(D) blood types were analyzed. RESLUTS: The discrepancy ratio between real and perceived ABO blood types was 1% but only 90.7% were confident of their ABO blood type. Only 58.3% were correctly answered to their Rh(D) blood type, and 98.7% of the donors who knew his or her Rh(D) blood type as negative were proved to be Rh(D) positive. The ABO discrepancy ratio was lower in females and it has decreased as blood donations increased (p<0.01). The discrepancy ratio increases with the age of the donor, and respondents over 30 had a higher discrepancy than those under 30 (p<0.01). Knowledge of Rh(D) blood type in transfusion was not well known to the general public. CONCLUSION: The study shows that the discrepancy ratio between real and perceived ABO blood type has decreased as a national blood donation rate has increased. Nevertheless, to increase the public's knowledge of blood type in relation to transfusion, especially to increase awareness of Rh(D) blood type, it is needed to conduct test exactly and to educate the result and general knowledge of blood type and tranfusion to the public.
Blood Donors ; Surveys and Questionnaires ; Female ; Humans ; Korea ; Questionnaires ; Red Cross ; Tissue Donors* ; Volunteers*

BACKGROUND/AIMS: The success of Helicobacter pylori eradication is limited by antibiotic resistances, and the primary resistance to metranidazole seems to be high. In this study, the frequency af metronidazole resistance and the eradication rate in metronidazole-resistant H. pylori strain was evaluated. METHODS: Sixty-eight patients were tested for metronidazole resistance using microdilution broth, the E test and disk diffusion method. Twenty-two patients were treated for 14 days with amoxicilline 2000 mg, metronidazole 750 mg, and tripotassium dicitrate bismuth 1200 mg. RESULTS: Metronida-zole resistance was 46% (31/68). The eradication rates for H. pylori was 91.7% in patients with metronidazole-sensistive strains and 70% in patients with metronidazole-resistant strains. CONCLUSIONS: Metronidazole resistance was high (46%) in Korea, however, triple therapy was an efficient method of eradicating H. pylori in both metronidazole sensitive and resistant strains.
Amoxicillin ; Bismuth ; Diffusion ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Metronidazole* ; Peptic Ulcer

BACKGROUND: Vancomycin is the drug of choice for the treatment of infections caused by methicillin- resistant Staphylococcus aureus(MRSA). However, vancomycin monotherapy of deep-seated staphylococcal infection may be associated with poor bacteriological response. Limited data suggest that vancomycin- gentamicin combination therapy is effective against MRSA. In this study, we evaluated the vancomycin- gentamicin synergism against MRSA and also investigated whether gentamicin susceptibility may affect the synergism. MATERIALS AND METHODS: The 51 strains of MRSA were obtained from patients at the Asan Medical Center from 1995 to 1996. The minimal inhibitory concentrations(MICs) of gentamicin were determined by the agar dilution method. The 25 strains with various levels of gentamicin MICs were chosen for time-kill studies. The MICs and minimal bactericidal concentrations(MBCs) of vancomycin were defined to determine vancomycin tolerance. Time-kill curves were established with vancomycin, gentamicin, and a combination of both. RESULTS: Gentamicin MICs ranged from 4 to 512microgram/mL. Only 7 of the 51 strains were gentamicin-susceptible and 44 were resistant. All of the 25 strains chosen were susceptible to vancomycin, but 16 of them showed tolerance. Vancomycin-gentamicin synergism was demonstrated in 5 of the 18 strains, in which the analysis of drug interaction was possible. In the remaining 13 strains, vancomycin and gentamicin interacted in a nonsynergistic manner. In all strains that showed synergism, the MICs of gentamicin were below 32microgram/mL. No synergism was demonstrated in strains with gentamicin MICs above 64microgram/mL. CONCLUSIONS: Although most of MRSA strains are resistant to gentamicin, synergistic interaction between vancomycin and gentamicin may be expected when the MIC of gentamicin is below 32 microgram/mL.
Agar ; Chungcheongnam-do ; Drug Interactions ; Gentamicins* ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Staphylococcal Infections ; Staphylococcus ; Vancomycin