Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained. On analyzing the quality of the ground water on patients's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analyzing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.
Bacteria ; Chickens ; Cyanosis ; Diarrhea ; Drinking ; Drinking Water ; Family Characteristics ; Fertilizers ; Groundwater ; Hematologic Tests ; Humans ; Infant* ; Manure ; Methemoglobin ; Methemoglobinemia* ; Plants ; Potassium ; Residence Characteristics ; Seoul ; Water ; Water Supply

Malignant fibrous histiocytoma, which is interesting because of its pleomorphic nature, is a rare soft tissue sarcoma possibly arising from histiocyte. The tumors are usually situated in the skin or subcutaneous tissues, especially of the extremities, but they may also involve deeper structures, such as the retroperitoneum or genital organs. Herin we report a case of malignant fibrous histiocytoma in the retroperitoneal space and discuss the pathologic and clinical features.
Extremities ; Genitalia ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous* ; Retroperitoneal Space ; Sarcoma ; Skin ; Subcutaneous Tissue

No abstract available.
Nevus, Intradermal

No abstract available.
Pulmonary Aspergillosis*

The sling operation is especially indicated in patients with intrinsic sphincter dysfunction (ISD). We evaluated of the effectiveness of the sling operation for the treatment of genuine stress incontinence patients with ISD. We operated 7 patients and followed up all of the patients for 214 (mean 8) months. Preoperative maximal urethral closure pressure was ranged from 23 to 74 (mean 38.4) cmH2O and valsalva leak point pressure (VLPP) was ranged from 41 to 78 (mean 59.5) cmH2O. We applied rectus fascia or GoreTex mesh as sling material. As a results, genuine stress incontinence (GSI) had completely cured in all of 7 cases. However, postoperative urinary retention was developed in two cases. In one of these, we released suspension suture, and in another case, urethrolysis and Raz operation was underwent in other hospital. All of these two cases showed improvement of voiding and any recurrence of incontinence was not noted. In conclusion, GSI due to ISD can be cured by the technique of the sling operation, so we suggest that the sling operation is one of the treatment for GSI patient with ISD.
Fascia ; Humans ; Polytetrafluoroethylene ; Recurrence ; Sutures ; Urinary Retention

No abstract available.
Granular Cell Tumor* ; Larynx*

No abstract available.

With an increasing trend toward low birth rates and premature births, the importance of managing the health of high-risk infants has received constant emphasis. It is necessary to establish a family-centered care culture in neonatal intensive care units where high-risk infants are hospitalized. This study is intended to examine the current status of family-centered care and the direction of the role played by healthcare professionals, focusing on the characteristics of high-risk infants and their families. Healthcare professionals should listen to the needs of the family and facilitate their involvement to improve the performance of family-centered care and systematic support. Specific guidelines are required to strengthen the competence and leadership of healthcare professionals. The paradigm shift toward family-centered care for high-risk infants is a challenge for healthcare professionals and parents, but it will serve as a vision and strategy to improve the health of high-risk infants and their families by including the family in the healthcare process.

BACKGROUND: Although current dietary guidelines recommend to increase the consumption of whole grain, these recommendations are mainly derived from the belief that replacing fats with carbohydrate may reduce risk of coronary artery disease (CAD) by improving serum lipids. Our objective was to evaluate whether the isocalorical replacement of refined rice with whole grain reduce CAD risk factors such as insulin demand and lipid peroxidation in CAD patients. METHODS: Thirty-eight male patients with CAD were provided with 70 g powder of whole grain (220 kcal) for 16 weeks, replacing cooked refined rice as a carbohydrate source of breakfast. An oral glucose tolerance test (OGTT) was performed in all subjects to determine the effect of whole grain consumption on serum concentrations of insulin and glucose in CAD patients with different degree of glucose tolerance. RESULTS: With the substitution of whole grain for refined rice, serum glucose concentrations decreased by 24% without altering body weight and energy intake. Estimates of daily fiber and vitamin E intakes increased by 24% and 50%, respectively. Whole grain consumption in CAD patients without diabetes decreased fasting glucose (22%) and the area under the curve (AUC) for insulin (26%) and glucose (19%) during an OGTT. CAD patients with diabetes also showed reductions in fasting glucose (27%) and AUC for glucose (25%) during the OGTT, compared with baseline values. Whole grain consumption reduced plasma malondialdehyde and homocysteine and urinary 8-epi-prostaglandin F 2alpha concentrations by about 30%. Lipid-corrected concentrations of alpha-carotene, retinol, alpha- and gamma-tocopherol and lycopene increased by 22-46%, compared with baseline values. Whole grain consumption decreased the percentage composition of w6 fatty acids of serum phospholipid increased by 14%. CONCLUSION: The replacement of refined rice with whole grain as a carbohydrate source of a meal showed significant beneficial effects on glucose, insulin and homocysteine concentrations and lipid peroxidation in CAD patients. These effects are likely to substantially reduce the risk factors of CAD and diabetes in CAD patients.
Area Under Curve ; Blood Glucose ; Body Weight ; Breakfast ; Edible Grain* ; Coronary Artery Disease* ; Coronary Vessels* ; Energy Intake ; Fasting ; Fats ; Fatty Acids ; gamma-Tocopherol ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Insulin* ; Lipid Peroxidation* ; Male ; Malondialdehyde ; Meals ; Nutrition Policy ; Plasma* ; Risk Factors ; Vitamin A ; Vitamin E ; Vitamins

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change. Results are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.
Decision Making ; Health Behavior ; Health Education ; Korea* ; Mammography* ; Mass Screening* ; Nursing ; Smoke* ; Smoking Cessation* ; Smoking*