The purpose of this study was to develop, implement and evaluate a nutrition education program for middle aged men at a worksite. To be read easily, induce interest, and selected at need, seven 6-page leaflet aets were developed, which was the most preferable from chosen by the subjects. The contents of leaflet set were [Changing life style], [Good food habit],[Weight control and diet],[Cardiovascualr disease and diet], [Alimentary disease and diet],[Diaabetes and diet],and [Liver disease and diet]. Nutrition education was provided for 61 middle aged men(30 professors, 31 office workers) at a worksite from 40 mins to one hour. And the level of nutrition knowledge and nutrition attitude were tested to evaluate the effects of the nutrition education program with a developed leaflet set before and after nutrition education. After the nutrition deucation. the nutrition knowledge score had increased significantly at p<0.001, from average 9.3 point to 11.4 point. The level of nutrition knowledge was increased significantly at p<0.001, and the prevalence of misconceptions and the uncertainty of knowledge were decreased significantly at p<0.05. There was a significant difference between professors and office workers both before and after the program. Also, there was a significant increase in the attitude about nutrition score after the program and this means that the subjects were flexibly more open minded about nutrition than before(from 39.9 point, at p<0.001). The difference in the nutrition attitude score between professors and office workers was not significant both before and after the nutrition deucation. The developed leaflet set was evaluated very positively in understanding, interest, timing, and usage by the subjects.
beta-Aminoethyl Isothiourea ; Education* ; Humans ; Male ; Middle Aged* ; Prevalence ; Uncertainty ; Workplace*

Although several reports about drug-resistant tuberculosis (TB) in North Korea have been published, a nationwide surveillance on this disease remains to be performed. This study aims to analyze the drug resistance patterns of Mycobacterium tuberculosis among the patients in the sanatoria of North Korea, especially during the period when second-line drugs (SLDs) had not yet been officially supplied to this country. The Eugene Bell Foundation (EBF) transferred 947 sputum specimens obtained from 667 patients from 2007 to 2009 to the Clinical Research Center, Masan National Tuberculosis Hospital (MNTH), South Korea. Four hundred ninety-two patients were culture positive for TB (73.8%). Drug susceptibility test (DST) was performed for the bacilli isolated from 489 patients. Over 3 quarters of the cases (76.9%) were multidrug-resistant (MDR)-TB. Additionally, 2 patients had extremely drug-resistant (XDR)-TB. Very high resistance to first-line drugs and low resistance to fluoroquinolones (FQs) and injectable drugs (IDs) except for streptomycin (S) were detected. A small but significant regional variation in resistance pattern was observed. Big city regions had higher rate of MDR-TB, higher resistance to FQs and IDs than relatively isolated regions. In conclusion, significant number of drug-resistant TB was detected in North Korean sanatoria, and small but significant regional variations in resistance pattern were noticeable. However, the data in this study do not represent the nationwide drug resistance pattern in North Korea. Further large-scale evaluations are necessary to estimate the resistance pattern of TB in North Korea.
Democratic People's Republic of Korea* ; Drug Resistance ; Fluoroquinolones ; Hospitals, Chronic Disease ; Humans ; Korea ; Mycobacterium tuberculosis ; Sputum ; Streptomycin ; Tuberculosis* ; Tuberculosis, Multidrug-Resistant

PURPOSE: The aim of this study was to determine the effectiveness of arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy. MATERIALS AND METHODS: Between May of 2006 and July of 2014, a total of 43 patients who had undergone surgery for primary osteoarthritis of the elbow with ulnar neuropathy were included in this study. We divided the subjects into two groups according to the method of surgery: group 1 (n=18) received mini-open ulnar nerve decompression only, and group 2 (n=25) received arthroscopic debridement with mini-open ulnar nerve decompression. Patients were assessed for the following clinical outcomes: visual analogue scales (VAS) score, range of motion of the elbow joint, Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder and hand (DASH) at the time before surgery and 6 months after surgery. We analyzed the recovery of the ulnar nerve by the McGowan grade and Bishop rating score preoperatively and at 6 months after the surgery. RESULTS: The VAS score, range of motion of the elbow joint, MEPS, and DASH showed significant statistical difference after the surgery (p <0.05). However, between the 2 groups, there was no significant difference. For the McGowan grade, all cases of both groups–except one case each group–showed at least one grade improvement. Moreover, group 2 showed a greater significant difference than group 1 (p=0.001). At the final follow-up, according to the Bishop rating score, group 2 had a greater significant difference than group 1 (p=0.036). CONCLUSION: Arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy is a useful technique, which has several advantages, including the benefits associated with a minimally invasive surgery and also the improvement of elbow joint function and excellent recovery of the ulnar nerve.
Arm ; Arthroscopy ; Debridement* ; Decompression* ; Elbow Joint ; Elbow* ; Follow-Up Studies ; Hand ; Humans ; Methods ; Minimally Invasive Surgical Procedures ; Osteoarthritis* ; Range of Motion, Articular ; Shoulder ; Ulnar Nerve* ; Ulnar Neuropathies* ; Weights and Measures

BACKGROUND: The purpose of the current study is to investigate anatomical relationships between the muscle overlying the distal transverse carpal ligament (TCL) and the thenar motor branch of the median nerve. METHODS: Of the 192 wrists that underwent open carpal tunnel release, a muscle belly overlying the TCL was observed on the distal margin of TCL in 25 wrists and ligament exposure could not be achieved without transection of it. We recorded surgical findings of these 25 wrists. The origin of the recurrent motor branch arising from the major median nerve was marked on the axial and coronal section diagrams of the wrist. RESULTS: The presence of muscle overlying the TCL was seen in 25 wrists (21 patients, 13%). The locations of origin were distributed not only on the radial side but anterior or ulnar side of the major median nerve. Abnormal branches originated from the unusual side in 14 cases (56% of those with a muscle overlying the TCL): central-anterior side in eight cases, ulnar-anterior side in five cases, and ulnar side in one case. These anomalous branches were frequently associated with the muscle belly overlying the TCL in our study regardless of the origin site. The branches were prone to cut if careless midline incision along the third web space was performed. Unusual origin and aberrant pathway of the recurrent thenar motor branch were associated with the presence of a muscle overlying the TCL. CONCLUSIONS: A thorough knowledge of the standard and variant anatomy of the muscle belly and recurrent motor branch in the carpal tunnel is fundamental to prevention of complications such as muscle wasting or atrophy by iatrogenic motor branch injury during carpal tunnel release.
Atrophy ; Carpal Tunnel Syndrome ; Humans ; Ligaments* ; Median Nerve* ; Muscles* ; Wrist

The treatment of a brachymetacarpia using conventional distraction osteogenesis requires holding an external fixator following distraction for stability, which causes prolonged discomfort that adversely affects the patient's daily activities. This paper reports a case of a 20-year-old male of brachymetacarpia treated with distraction osteogenesis combined with a plate reducing the period of an external fixator, allowing rapid return to the daily activities, and presenting good clinical results.
External Fixators ; Humans ; Male ; Osteogenesis, Distraction ; Young Adult

BACKGROUND: Residual pleural thickening(RPT) develops in about 50% of tuberculous pleurisy(PLTB). Some reports have suggested that elevated TNF-α and impaired fibrinolysis could be the cause of RPT, but until now, the mechanism and predictors of RPT have not been well known. TGF-β has been known to promote fibrogenesis and is increased in tuberculous pleural fluid(PF). PLTB and malignant pleurisy(PLMAL) manifest lymphocyte-dominant exudative pleural effusion, and it has clinical implications in the differentiation of the two diseases, based on the findings of pleural effusion. We performed this study to compare pleural fluid TNF-α, TGF-β, and fibrinolytic parameters between PLTB and PLMAL, and to find the predictors of RPT in PLTB. METHODS: Thirty-five PLTB and 14 PLMAL patients who were admitted to the Asan Medical Center from February 1997 to August 1999 were enrolled. All PLTB patients were prescribed a primary, short-course, anti-tuberculosis regimen. TNF-α, tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1), plasminogen, α2-antiplasmin, and D-dimer were measured in both PF and PB, TGF-β was measured only in PF. Clinical characteristics, TNF-α, TGF-β, and fibrinolytic parameters were compared between patients with RPT less than 2 mm and patients with more than 2 mm of the thirty patients who completed the anti-tuberculosis treatment. RESULTS: The levels of TNF-α, tPA, PAI-1, plasminogen, α2-antiplasmin, and D-dimer in PF were higher than those in peripheral blood (PB) in PLTB, whereas only plasminogen, α2-antiplasmin, and D-dimer were higher in PF than in PB in PLMAL. Pleural fluid TNF-α, TGF-β, PAI-1, plasminogen, α2-antiplasmin were increased in PLTB compared with PLMAL, but these factors did not show any further advantages over ADA in differentiation between PLTB and PLMAL. TNF-α, TGF-β, and fibrinolytic parameters did not show any differences between patients with RPT less than 2 mm and patients with RPT more than 2 mm. CONCLUSION: Our data suggest that TNF-α, TGF-β, and fibrinolytic parameters may play some role for the development of RPT in PLTB, but they failed to predict the occurrence of RPT in PLTB. Also these parameters did not seem to have any advantages over ADA in differentiating between two diseases.
Chungcheongnam-do ; Fibrinolysis ; Humans ; Plasminogen ; Plasminogen Activator Inhibitor 1 ; Pleural Effusion ; Pleural Effusion, Malignant* ; Tissue Plasminogen Activator ; Transforming Growth Factor beta* ; Tuberculosis, Pleural ; Tumor Necrosis Factor-alpha*

BACKGROUND: The mortality from acute respiratory distress syndrome(ARDS) in the late stage, which is characterized by progressive pulmonary fibroproliferation, is >or=80%. Although previous prospective trials failed to show a survival benefit of steroid therapy in early ARDS, recently, a few of reports have described the survival benefit of the long-term use of steroid in patients with late ARDS. In this study, we analyzed the effect of steroid therapy on patietns with late ARDS. In this study, we analyzed the effect of steroid therapy on patients with late ARDS retrospectively in a single. Medral intensive care unit. METHODS: Over a 3-year period, the medical records of 48 ARDS patients who had veen on mechanical ventilation more than 8 days were reviewed. 14 patients were treated by the long-term use of methylprednisolone and another 34 patients served as a control. Both groups were comparable regarding clinical and physiologic data lung injury score(LIS), multiple organ failure score, APACHE III and SAPS II score. Because steroid was instituted after 8 days of advanced mechanical ventilatory support in average, we arbitrarily defined the 8th day of ARDS as first day of the study. RESULTS: Initially, the group had similar PF(PaO2/FiO2)ratio, LIS, APA CHE III and SAPS II score. By 7th day after the start of steroid therapy, there were significant improvements in PF ratio, LIS, APACHE III and SAPS II score. The mortality in the steroid treated group was significantly lower(42.9% vs 73.5%, p<0.05). CONCLUSIONS: Although the data of this study was retrospective and was not randomized, in order to improve the patients's outcomes, steroid therapy should be considered in late ARDS patients. However, prospective trials are needed to define the indication and the effect of steroid therapy in late ARDS.
APACHE ; Humans ; Intensive Care Units ; Lung Injury ; Medical Records ; Methylprednisolone ; Mortality ; Multiple Organ Failure ; Prospective Studies ; Respiration, Artificial ; Retrospective Studies

To explore the following hypotheses: 1) Gas exchange, Organ failure, Cause, Associated disease (GOCA) score, which reflects both general health and the severity of lung injury, would be a better mortality predictor of acute respiratory distress syndrome (ARDS) than acute physiology and chronic health evaluation (APACHE II) or simplified acute physiology score (SAPS II), which are not specific to lung injury, and lung injury score (LIS) that focuses on the lung injury; 2) the performance of APACHE II and SAPS II will be improved when reinforced by LIS, we retrospectively analyzed ARDS patients (N=158) admitted to a medical intensive care unit for five years. The overall mortality of the ARDS patients was 53.2%. Calibrations for all models were good. The area under the curve of (AUC) of LIS (0.622) was significantly less than those of APACHE II (0.743) and SAPS II (0.753). The AUC of GOCA (0.703) was not better than those of APACHE II and SAPS II. The AUCs of APACHE II and SAPS II tended to further increase when reinforced by LIS. In conclusion, GOCA was not superior to APACHE II or SAPS II. The performance of the APACHE II or SAPS II tended to improve when combining a general scoring system with a scoring system that focused on the severity of lung injury.
APACHE ; Adult ; Aged ; Critical Illness/mortality ; Female ; Humans ; Intensive Care ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; *Pulmonary Gas Exchange ; ROC Curve ; Respiratory Distress Syndrome, Adult/*mortality/*physiopathology ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; *Severity of Illness Index ; Survival Analysis

Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.
Aged ; Biopsy ; Bone Marrow ; Cough ; Diagnosis ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Tract ; Helicobacter pylori ; Humans ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiography, Thoracic ; Solitary Pulmonary Nodule* ; Stomach ; Tomography, X-Ray Computed

Aspergillus tracheobronchitis is one form of invasive pulmonary aspergillosis which is characterized by ulcers and pseudomembrane formation in tracheobronchial tree. In Aspergillus tracheobronchitis, the infection is often limited to the mucosa and it accounts for less than 10 percents of invasive disease. Invasive aspergillosis mainly occurs in immunocompromized patients with prolonged neutropenia, advanced AIDS, organ transplantation, high-dose glucocorticoid therapy or cytotoxic therapy although it can occur in less immunocompromised patients, such as after influenza, COPD, old age, and diabetes. We report a case of Aspergillus tracheobronchitis in a 61 year-old patient with diabetes and Child Pugh class A liver cirrhosis. He presented with cough and purulent sputum for 10 days. He was diagnosed by bronchoscopy and successfully treated with antifungal therapy.
Aspergillosis ; Aspergillus ; Bronchitis ; Bronchoscopy ; Child ; Cough ; Diabetes Mellitus ; Humans ; Immunocompromised Host ; Influenza, Human ; Invasive Pulmonary Aspergillosis ; Liver Cirrhosis ; Mucous Membrane ; Neutropenia ; Organ Transplantation ; Pulmonary Disease, Chronic Obstructive ; Sputum ; Transplants ; Ulcer