Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona, Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term 'chronic pulmonary coccidioidomycosis'is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed fianlly by lobectomy and histologic examination.
Arizona ; California ; Coccidioides ; Coccidioidomycosis* ; Cough ; Diagnosis ; Endemic Diseases ; Female ; Humans ; Inhalation ; Lung ; Nevada ; New Mexico ; Pneumonia ; Solitary Pulmonary Nodule*

STATEMENT OF PROBLEM: Elastomeric impression materials have been widely used to obtain an accurate impression. However there have not been enough studies on the influence of the thickness of the tray adhesives on the bonding strength between the trays and the elastomeric impression materials. PURPOSE: In order to understand the relationship between the thickness of the tray adhesive and the tensile bond strength and to suggest the thickness at which the bonding strength is strongest, tensile bond strength related to the thickness of adhesives of 3 different elastomeric impression materials were tested. MATERIALS AND METHODS: 3 impression materials, Permlastic(R) Regular Set(Kerr Corp., Romulus, Michigan, U.S.A.), Impregum(TM) Penta(TM)(3M ESPE, Seefeld, Germany), and Aquasil Ultra Monophase Regular Set Smart Wetting(R) (Dentsply Caulk, Milford, Delaware, U.S.A.), were used in this study, and tray adhesives from the same manufacturers of the impression materials were used, which were Rubber Base Adhesive, Polyether Adhesive, and Silfix, respectively. The tray specimens were prepared by autopolymerizing the tray material(Instant Tray Mix, Lang, Wheeling, Illinois, U.S.A.), and a PVC pipe was used to house the impression material. In group A, tray adhesives were applied in multiple thin layers of 1 to 5 and in group B, adhesives were applied only once, in the thickness equivalent to several applications. Lightness(L*) of the adhesion surface was measured with a spectrophotometer (CM-3500d, Konica Minolta, Sakai, Osaka, Japan). The tensile bond strength of the elastomeric impression material and the tray resin was measured with universal materials testing machines(Instron, Model 3366, Instron Corp, Nowood, Massachusetts, U.S.A.). A formula between the number of adhesive application layers and the lightness of the adhesion surface was deduced in group A, and the number of adhesive layers in group B was estimated by applying the lightness(L*) to the deduced formula. RESULTS: 1. In group A, a statistically significant increase in tensile bond strength appeared when the number of application layers increased from 1 to 2 and from 4 to 5, and no significant difference was present between 2, 3, and 4 layers in Permlastic. In Impregum, the tensile bond strength was significantly increased when the number of adhesive layers increased from 1 to 3, but no significant difference after 3 layers. In Aquasil, the tensile bond strength significantly increased as the number of application layers increased up to 4 but showed no significant difference between 4 and 5. 2. In group B, the tensile bond strength was decreased when the thickness of the adhesive increased in Permlastic. Impregum showed an increased tensile bond strength when the thickness of the adhesive was increased. In Aquasil, the tensile bond strength increased as the number of adhesive application layers increased up to approximately 2.5 layers but it sharply decreased after approximately 4.5. CONCLUSION: From the study, the common idea that it is better to apply a thin and single coat of tray adhesive needs correction in more detailed ways, and instructions on some of the tray adhesives should be reconsidered since there were several cases in which the tensile bond strength increased according to the increase in the thickness of the adhesives.
Adhesives* ; Delaware ; Elastomers* ; Illinois ; Massachusetts ; Materials Testing ; Michigan ; Rubber

This study was conducted to compare the body image perception, weight control experiences and the eating disorders according to where they were born, and the length of residence in USA among Korean-American college students. Three hundred college students participated in the study: 144 males and 156 females, 122 America-born (AB) and 171 Korea-born (KB) who live in New York City and New Jersey. Subjects responded to a self-administered questionnaire. The results showed that the ratio of overweight (23.2%) and obesity (26.8%) of males was higher than females' (16.1% and 6.3%, respectively). There were no significant differences according to born-place or the length of residence in USA of KB. People who had tried to control their weight were 58%. The ratio of weight control experiences of females (72.4%) was higher than males' (42.4%) as well as people who were normal or underweight than who were overweight or obesity. There were no significant differences according to born-place or the length of the residence in the USA of KB. In body image perception, the subjects who were normal and underweight overestimated their body figure, and the subjects who were overweight and obese underestimated their body figure. The desired and ideal figure of female students was significantly thinner than the current figure and also that of male students. There were no significant differences according to born-place or the length of the residence in USA of KB. The ratio of eating disorder was 8.7%, and females had higher percentage than males. And shorter they lived in USA, the percentage of eating disorder was higher.
Asian Americans ; Body Image ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Male ; New Jersey ; New York City ; Obesity ; Overweight ; Surveys and Questionnaires ; Thinness ; Weight Perception

Investigations of Enterobius sp. infection in prehistory have produced a body of data that can be used to evaluate the geographic distribution of infection through time in the Americas. Regional variations in prevalence are evident. In North America, 119 pinworm positive samples were found in 1,112 samples from 28 sites with a prevalence of 10.7%. Almost all of the positive samples came from agricultural sites. From Brazil, 0 pinworm positive samples were found in 325 samples from 7 sites. For the Andes region, 22 pinworm positive samples were found in 411 samples from 26 sites for a prevalence of 5.3%. Detailed analyses of these data defined several trends. First, preagricultural sites less frequently show evidence of infection compared to agricultural populations. This is especially clear in the data from North America, but is also evident in the data from South America. Second, there is an apparent relationship between the commonality of pinworms in coprolites and the manner of constructing villages. These analyses show that ancient parasitism has substantial value in documenting the range of human behaviors that influence parasitic infections.
Americas* ; Brazil ; Enterobius* ; Humans ; North America ; Prevalence ; South America

Blastomycosis is a systemic pyogranulomatous disease that is caused by a thermally dimorphic fungus, Blastomyces dermatitidis. it's the disease is endemic in the south-eastern and south central states of the USA, which border the Mississippi and Ohio Rivers, the mid-western states and Canadian provinces bordering the Great Lakes as well as in a small area of New York and Canada adjacent to the St. Lawrence River.1 We encountered a case of blastomycosis, representing as a pulmonary manifestation after traveling around a non-endemic area and report it with a brief review of the relevant literature.
Blastomyces ; Blastomycosis* ; Canada ; Fungi ; Lakes ; Mississippi ; Ohio ; Rivers

PURPOSE: Preamplifier and amplifier are very important parts for developing a portable counting or imaging gamma probe. They can be used for analyzing pulses containing energy and position information for the emitted radiations. The commercial Nuclear Instrument Modules (NIMs) can be used for processing these pulses. However, it may be improper to use NIMs in developing a portable gamma probe, because of its size and high price. The purpose of this study was to develop both preamplifier and amplifier and measure their performance characteristics. MATERIALS and Methodes: The preamplifier and amplifier were designed as a charge sensitive device and a capacitor resistor-rsistor capacitor (CR-RC) electronic circuit, respectively, and they were mounted on a print circuit board (PCB). We acquired and analyzed energy spectra for Tc-99m and Cs-137 using both PCB and NIMs. Multichannel analyzer (Accuspec/A, Caberra Industries Inc., Meriden Connecticut, U.S.A) and scintillation detectors (EP-047 (Bicron Saint-Gobain/Norton Industrial EP-047 (Ceramics Co., Ohio, U.S.A) with 2"x2" NaI (T1) crystal and R1535 (Hamamatsu Photonics K.K., Electron Tube Center, Shizuoka-ken, Japan) with 1"x1"NaI (T1) crystal) were used for acquiring the energy spectra. RESULTS: Using PCB, energy resolutions or EP-047 detectors for Tc-99m and Cs-137 were 12.92% and 5.01%, respectively, whereas R1535 showed 13.75% and 5.19% of energy resolution. Using the NIM devices, energy resolutions of EP-047 detector for Tc-99m and Cs-137 were measured as 14.6% and 7.58%, respectively. However, reliable energy spectrum of R1535 detector could not be acquired, since its photomultiplier tube (PMT) requires a specific type of preamplifier. CONCLUSION: We developed a special preamplifier and amplifier suitable for a small sized gamma probe that showed good energy resolutions independent of PMT types. The RESULTS indicate that the PCB can be used in developing both counting and imaging gamma probe.
Connecticut ; Ohio ; Optics and Photonics

The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.
Female ; Humans ; Incidence ; Male ; Melanoma* ; New Mexico ; Seoul ; Solar System

Problem-based learning(PBL) is widely used as an effective educational tool; the fields in which it has been applied include medicine. Several reports have described the results of trials comparing problem-based and conve ntional approaches to learning; none, however, have compared the results between two groups where one had not undergone medical training, and the other had been partially trained, using the conventional approach. The aim of this study was to determine whether there was any difference in medical performance between two groups, as described above. Before the possible incorporation of PBL into our curriculum, we also wished to investigate many possible problems. Group A consisted of five premedical school students and group B of six students in the first year of medical school at our college. The same case which had been used in the tutor training program in the University of New Mexico School of Medicine was used by the same tutor who attended that program, and the whole procedure was evaluated by other faculty members through closed-circuit TV monitor. We also analyzed the results of evaluation by the tutors and students themselves. The general performance of the students was excellent, while the performance of the tutors were acceptable. Many possible problems, including library facilities and educational environments were also discussed. In conclusion, PBL is an approach which can be used in our medical college from an early stage. Before it is fully introduced, however the large number of potential problems should be carefully evaluated.
Curriculum ; Education ; Humans ; Learning* ; New Mexico ; Schools, Medical

Due to great concern about quality of care in nursing home, legislative in the US mandated development of LTC MDS. MDS, a standardized assessment database for nursing home residents, provides comprehensive, holistic assessment data for nurses and make it possible to identify nursing needs of residents. The purpose of this study is to assess the health status of nursing home residents in Missouri, America, and to stimulate international comparative research assessing the health status of the elderly. This study presented the age-specific prevalence of diseases, sex differences, and the relative prevalence of chronic diseases among nursing home residents using the Minimum Data Set in Missouri. In addition, the possibility of racial and regional differences in chronic diseases and its relationship to demographic factors were analyzed. The prevalence of diseases was, in general, higher in female elderly then males and increased with age in both sexes. The average number of diseases in the elderly, among 31 chronic diseases, was 3.43 in women and 3.25 in men. The most prevalent 5 diseases were hypertension (29.1%), congestive heart failure (26.1%), dementia (23.6%), arthritis (20.6%), and diabetes mellitus (17.7%). Sixty-eight percent of nursing home residents had at least one of the heart/circulation related diseases and 58. 4% had neurology related diseases. In conclusion, the usefulness and implication of LTC MDS to nursing can't be overemphasized. Korean nurses should prepare themselves for using it for nursing research and to answer nursing questions.
Aged ; Americas ; Arthritis ; Chronic Disease* ; Dataset* ; Dementia ; Demography ; Diabetes Mellitus ; Female ; Heart Failure ; Humans ; Hypertension ; Male ; Missouri* ; Neurology ; Nursing Homes* ; Nursing Research ; Nursing* ; Prevalence* ; Sex Characteristics

OBJECTIVES: Zika virus, which was first discovered in 1947, has become a global threat to human health as it is rapidly spreading through Latin America, the Caribbean, the US and Asia, after causing a large outbreak in the Northeast region of Brazil in 2015. There is ample evidence to support that Zika virus is associated with neurological complications such as microcephaly. The review aims to provide an overview on the complex issues involved in the emergence of Zika virus's neurological disorders and to discuss possible explanations of Zika virus introduction and dissemination in Brazil. We also suggest national and global strategies to adequately respond to the Zika virus emergence. METHODS: We provide an analytical evaluation of the main issues related to the Zika outbreak in Brazil, based on available scientific literature, including government documents, and on epidemiological information from national surveillance databases. RESULTS: The studies on the clinical manifestations of the Zika virus infection coupled with the epidemiological surveillance information in Brazil have provided significant evidence that the Zika virus is associated with neurological disorders such as microcephaly and Guillain-Barré syndrome. Based on phylogenetic and molecular analysis, the hypothesis regarding the introduction of Zika virus in the country is that it took place following international events in 2013 and 2014, when many foreign visitors could have brought Zika virus into Brazil. The immunologically naïve status of populations in the Americas, previous infection with dengue virus, and the increased activity of Aedes aegypti might be the contributing factors for such an outbreak in Brazil. The Zika virus emergence emphasized the importance of cross-disciplinary perspective. Besides the scientific-based vector control strategies, it is important to understand the nature of the evolutionary processes involved in the viral evolution in complex ecosystems and to have social and anthropological knowledge on the conditions related to the spread of the disease in order to properly respond to the spread of the Zika virus. CONCLUSIONS: The experiences of Brazil have demonstrated the significance of multi-disciplinary approach in response to new and resurgent arboviral diseases and provided important lessons that could be applied to other developing countries.
Aedes ; Americas ; Asia ; Brazil* ; Caribbean Region ; Dengue Virus ; Developing Countries ; Ecosystem ; Epidemiology ; Guillain-Barre Syndrome ; Humans ; Latin America ; Microcephaly ; Nervous System Diseases ; Zika Virus ; Zika Virus Infection