A study on the infection status of intermediate hosts of Paragonimus, snail and crab, was conducted on Che Ju Island for four years to understand ecology of Paragonimus in the area and to evalute the control program by mass chemotherapy The infection rate of the first intermediate host of Paragonimus, snail, showed higher rate in the area where human association was more frequent and had higher human infection rate compared with the area with lower human infection and less contact by people. Larger snails were infected more frequently than smaller ones. After the mass treatment on human population, the infection rate of snail dropped markedly in four years. The infection rate and the intensity of infection of crabs were influenced by many factors:by frequency of human association, by prevalence of paragonimiasis in the population and volume of water flow, dilution effect. The distribution of metacercariae in infected crabs varied by body sites; the most frequently in gill, next in legs, internal organs and thoracic muscle in order. If crabs were examined for existence of metacercariae only gills, about 6% of infected crabs of may be missed as negative. The infection status of the crabs was not different by distance from the actual site of pollution. Also seasonal fluctuation of crab infection was not remakable. The crab infection by size showed time sequence of exposure; smaller crabs had lower infection rate and metacercaria density reaching to the maximum by 3 cm of size. As shown in the snail infection, the crab infection remarkably decreased after the control measure of human paragonimiasis, mass chemotherapy, in four years.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus westermani ; metacercaria ; epidemiology ; snail ; crab ; host ; chemotherapy

No abstract available.
Korea*

No abstract available.
Herpes Simplex*

No abstract available.
Bioterrorism*

An evaluation of intradermal test in screening paragonimiasis was attempted by comparing antigens, filtered through Sephadex G 50, fractionated by DEAE Sephadex A 25, and V.B.S.(crude extract of adult worms) antigen on 402 school children. The sensitivity and false negative rates were compared with one another on results of two examinations for eggs, one with sputum and the other with stool. The purified antigens showed more intense skin reaction than the crude extract. The crude extrct(V.B.S.) appeared to have lower false negative rate than the purified even though the difference was not statistically significant. Intradermal test with V.B.S. antigen on 12,000 subjects was analysed to find some characteristics of the reaction. Three size groups were classified by egg detection rate; negative reaction, 20-50 mm(2) size group of which egg detection rate was 3.5% among 118 persons, intermediate, 60-100 mm(2) with 26.8% among 1,078, and positive reaction, larger than 100 mm(2) with 45.7% among 2,098 subjects. The distribution of wheal size by age for total population surveyed revealed that younger ages had smaller wheal sizes with larger proportion of negative reaction, which decreased when the age increased. Skin sensitization in a population seemed to occur gradually to and reached a maximum by the age of 13 year. The egg detection rate increased proportionately to wheal size for the intermediate group, however, it did not vary much by size for positive group(larger than 100 mm(2)). When the wheal size distributions were compared in three groups, egg positives, egg negatives, and the group whose sputa were not examined, curves of the two groups, egg positive and negative, did not show clear separation. This fact seems to indicate that there is a low sensitivity and specificity in both tests(sputum and skin). The stability of the intradermal test measured by a second survey done one year after the primary survey revealed that the intermediate size group had more marked unstability than the other groups, and the treated group had tendency to decrease in wheal size. The purification of antigen for intradermal test did not add any better means of screening for paragonimiasis, probably due to the nature of skin sensitization evoked by many elements of the parasite but not by a few selected components. The V.B.S. antigen may be valuable for screening a large population, yet the diagnosis can not be dependent entirely upon the test. The final diagnosis should be made by repeated sputum examinations in spaced time with careful history taking aided by CF test and X-ray examination if necessary.
parasitology-helminth-trematoda ; Paragonimus westermani ; epidemiology ; diagnosis ; skin test ; specificity ; sensitivity

Among 11,005 inhabitants(61% of total population) surveyed in 13 villages of Che Ju Island in 1964, were identified as paragonimiasis patients, of these 1,355 were treated with 40 mg/kg body weight of bithionol for 10-15 doses. The purpose of the study was to test whether mass chemotherapy of the human host may provie an answer for the control of paragonimiasis in an area where the human host is main source of infection to the intermediate hosts. The efficacy of the mass chemotherapy as control program was measured by the acceptance of the survey and treatment by the inhabitants, the efficacy and the toxicity of the drug applied, and the influence of the infection rates of the intermediate hosts. The acceptance of the survey and the treatment was not entirely satisfactory: an estimate based on data suggests that only fifty to sixty percent of all cases infected were detected, and 93% of detected cases were treated in the primary program. All cases detected during the follow up survey, which could not cover whole population, were treated. The efficacy of bithionol was excellent when the treatment was completed. 40 mg/kg body weight for 10-15 doses was sufficient to turn the sputum egg-negative except in a few cases infected heavily that needed 20 doses. Side reactions were generally mild; the most frequent reaction was gastrointestinal; which spontaneously subsided within a few to several days. The infection rate of intermediate hosts started to decrease from the third year of the mass treatment with a pattern of gradual drop. Follow up studies on general population in three and four years of the mass treatment also showed markedly decreased prevalence of paragonimiasis by intradermal test and sputum examination. It is concluded that a complete mass chemotherapy with bithionol in an area where human is the main source of infection to the intermediate hosts can be the answer for control of paragonimiasis.
parasitology-helminth-trematoda ; Paragonimus westermani ; epidemiology ; chemotherapy ; bithionol

No Abstract available.
Cross Infection* ; United States*

This Qualitative nursing research used a hermeneutic phenomenological approach to discover meaning in an aging experience. The ultimate aim of the inquiry was to discover the essence of aging experience and to promote understanding. The study used Van Manen's methodology of phenomenological research. Multiple strategies for data collecting were utilized : in depth face-to-face interview & analysis of elder's literature. The following themes of experience emerged : changing of physical shape, being expelled out in the field of life, reformationing of family relationship, rhythmical patterning of life & death, developing of reflective self-consciousness, awareness of self-expansion creatively. From this study essential themes for understanding aging experience, need for continuing inquiry were identified.
Aging* ; Family Relations ; Nursing Research

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.
Adult ; Analgesics* ; Antipsychotic Agents ; Anxiety ; Humans ; Hypnotics and Sedatives* ; Ketoprofen ; Medical Records ; Midazolam ; Narcotics ; Neurosurgery ; Prescriptions ; Research Personnel ; Respiration, Artificial ; Vital Signs

Detecting eggs from feces and/or sputum is probably closely associated with many factors such as degree or intensity of infection, physiological status of the host(age, eating habit and duration of residence in the area), the duration of infection for the parasite (age and reproductive activity of flukes), and methods of collecting specimens and technique of examination. Neverthless, it is difficult to determine which factor plays the most inportant role in detecting eggs except comparison of factual result obtained by standardized techniques. The purpose of the study was to find out which method would give better result for detection of eggs, and to estimate what proportion of patients would be missed when the method selected is used. On a single examination of both specimens, stool and sputum, collected from the same person, sputum examination was found to be superior to stool examination for detection of eggs; 37 of 40 egg positives had eggs in sputum whereas only 21 of 40 in stool. Repeated sputum examination on the same subject in spaced time gave higher overall egg detection rate; in the first examination for all skin reaction positives, the detection rate was 36.8%, in the second examination on those who had negative results in the first examination, it was 11.6% among 602 persons examined, and 5.3 percent of 95 persons who were negative in previous two examinations. Thus, repeated sputum examinations (three times) increased the overall detection rate to 48.5% from 36.8%. According to the result obtained through this study, it would be worthwhile to recommend repeated sputum examinations at least three times on the same subject even if collecting second and third sputum is quite difficult problem in mass survey; about 12% of total patients who can be detected as positive by three times repeated examinations shall be missed if only a single sputum examination is done.
parasitology-trematode-Paragonimus westermani ; diagnosis ; sputum examination ; stool examination skin test