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

No abstract available.
Humans ; Motor Vehicles*

Pulmonary endometriosis is a rare disease which is characterized by hemoptysis during menstruation (catamenial hemoptysis). We report a case of pulmonary endometriosis in a 33-year-old housewife. She has had regular menses with moderate flow and minimal dysmenorrhea. She had undergone curettage in May 1995 for artificial abortion. In July 1995, she experienced the first episode of hemoptysis. A chest CT scan revealed a 2.0 1.0 cm sized ill-defined soft tissue density in the periphery of anterior segment of the left upper lobe with a surrounding irregular ground-glass opacity. A left upper lobectomy was done under the diagnosis of pulmonary endometriosis. Cut section of the resected lung showed a round red-brownish solid lesion, measuring 2.0x1.0cm in cross. Microscopically a focus of the endometrial tissue, which was composed of endometrial glands and stroma, was found in the lung parenchyme and many hemosiderin laden macrophages were seen in the surrounding alveoli. The postoperative course was favorable with no further episodes of hemoptysis.
Adult ; Curettage ; Diagnosis ; Dysmenorrhea ; Endometriosis* ; Female ; Hemoptysis ; Hemosiderin ; Humans ; Lung ; Macrophages ; Menstruation ; Rare Diseases ; Tomography, X-Ray Computed

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

BACKGROUND: It is difficult to control an outbreak of Shigella infection, because of the ease of transmission and the resistance to multiple antibiotics. Recently, there were outbreaks of Shigella infection in Chinju area. The objective of this study was to investigate the molecular epidemiology of the outbreaks using pulsed-field gel electrophoresis(PFGE). METHOD: Thirteen S. flexneri strains, 25 S. sonnei strains from Chinju and 15 S. sonnei strains from Pusan were studied. All strains were isolated from stool cultures of diarrheal patients. Identification and antimicrobial susceptibility test those were tested by Vitek GNI and GNS-LH. Chromosomal DNA restricted with Xbal was resolved by PFGE. RESULT: All the S. flexneri strains and 23(92%)S. sonnei strains from Chinju were resistant to one or more antimicrobial agents. All the clinical isolates of S. flexneri showed the same PFGE pattern which was different from type strains(KTCC 2517). PFGE patterns of 25 (100%) S. sonnei strains from Chinju and 12 (80%) S. sonnei strains from Pusan were identical to those of type strain (KTCC 2009). Three S. sonnei strains from Pusan showed distinct PFGE patterns, respectively. CONCLUSION: PFGF demonstrated identical restriction pattern among most of Shigella isolates from Chinju and Pusan, indicating that an outbreak with genetically related strains had occurred. PFGE was useful in molecular epidemiology of Shigella outbreaks
Anti-Bacterial Agents ; Anti-Infective Agents ; Busan ; Disease Outbreaks ; DNA* ; Gyeongsangnam-do ; Humans ; Molecular Epidemiology ; Shigella

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

Purpose: This study examined the impact of self-esteem and social support on self-care performance of liver transplantation recipients. Methods: In this correlational study, 101 recipients were recruited from a general hospital-affiliated outpatient clinic using a convenience sampling. Participants were asked to administer questionnaires of the self-esteem, the social support, and self-care performance. Data were analyzed by descriptive statistics, Pearson’s correlation coefficients, and hierarchical linear regression. Results: Self-care performance of patients with liver transplantation was significantly different by gender, age, education level, and support group meeting. After controlling for these covariates, social support significantly influenced on self-care performance (β=.25, p=.010, adjusted R 2 .=.058). Conclusion Social support from medical team and family members is a critical factor to promote self-care performance level for liver transplantation recipients.

No abstract available.
Animals ; Autoimmunity* ; Mice*

A xanthoma is a localized collection of tissue histiocytes containing lipid and is usually associated with hyperlipidemia. Tendinous and tuberous xanthomatosis have been found in association with familial hypercholesterolemia, Type III hyperlipidemia, beta-sitosterolemia and cerebrotendinous xanthomatosis. Tendinous and tuberous xanthomatosis without hyperlipidemia have been reported very rarely. Especially tendinous xanthomatosis without hyperlipidemia have not been reported at all in korea. We are reporting a patient with tendinous and tuberous xanthomatosis accompanied by normal plasma lipids
Histiocytes ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II ; Korea ; Plasma ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous

Laparoscopic resection of appendiceal mucoceles has recently been described, but the safety and efficacy are controversial. We present two cases of laparoscopic mucocelectomies involving 14 and 15 cm cystic masses originating from the appendix. The laparoscopic mucocelectomies were performed using four ports. From the beginning of the procedure, a laparoscopic bag was used to safely contain the mucocele, prevent rupture of the mucocele, and retract the mucocele. An endoscopic stapling device was used to transect the base of the cecum. Minimal handling was achieved by gravity and with the use of laparoscopic instruments. Laparoscopic appendectomies are widely performed for acute appendicitis, but laparoscopic resection is not routinely performed for an appendiceal mucocele because of the risk of perforation and subsequent pseudomyxoma peritonei. We report two cases of laparoscopic appendiceal mucocelectomies, which were performed safely with laparoscopic instruments and minimal manipulation.
Appendectomy ; Appendiceal Neoplasms ; Appendicitis ; Appendix ; Cecum ; Gravitation ; Handling (Psychology) ; Laparoscopy ; Mucocele ; Pseudomyxoma Peritonei ; Rupture