We report two cases of subacute combined degeneration (SCD) caused by nitrous oxide (N₂O) gas intoxication, which is rarely reported in Korea. Two patients recreationally inhaled N₂O gas daily for several months. They presented with paresthesia of limbs, voiding difficulty, and gait disturbance. The initial vitamin B₁₂ levels were normal or decreased, but homocysteine levels of the two patients were increased. Magnetic resonance imaging of the cervical spine showed T2-weighted hyperintensity in the bilateral dorsal columns of the cervical spinal cord. Electromyography and somatosensory evoked potential tests for both patients suggested posterior column lesion of the spinal cord combined with sensorimotor polyneuropathy. According to these findings, we concluded that the two patients had SCD. The patient’s symptoms partially improved after cessation of N₂O gas inhalation and the receiving of vitamin B₁₂ supplementation therapy. As the incidence of recreational N₂O gas inhalation is increasing in Korea, physicians must be alert to the N₂O induced SCD in patients presenting with progressive myelopathy.
Cervical Cord ; Electromyography ; Evoked Potentials, Somatosensory ; Extremities ; Gait ; Homocysteine ; Humans ; Incidence ; Inhalation ; Korea ; Magnetic Resonance Imaging ; Nitrous Oxide ; Paresthesia ; Polyneuropathies ; Recreation ; Spinal Cord ; Spinal Cord Diseases ; Spine ; Subacute Combined Degeneration ; Vitamin B 12 ; Vitamins

Waterborne parasitic protozoa, particularly Giardia lamblia and Cryptosporidium spp., are common causes of diarrhea and gastroenteritis worldwide. The most frequently identified source of infestation is water, and exposure involves either drinking water or recreation in swimming pools or natural bodies of water. In practice, studies on Cryptosporidium oocysts and Giardia cysts in surface water are challenging owing to the low concentrations of these microorganisms because of dilution. In this study, a 3-year monitoring of Cryptosporidium parvum, Giardia lamblia, and Naegleria fowleri was conducted from August 2014 to June 2016 at 5 surface water sites including 2 lakes, 1 river, and 2 water intake plants. A total of 50 water samples of 40 L were examined. Cryptosporidium oocysts were detected in 22% of samples and Giardia cysts in 32%. Water at the 5 sampling sites was all contaminated with Cryptosporidium oocysts (0–36/L), Giardia cysts (0–39/L), or both. The geometric mean concentrations of Cryptosporidium and Giardia were 1.14 oocysts/L and 4.62 cysts/L, respectively. Thus, effective monitoring plans must take into account the spatial and temporal parameters of contamination because they affect the prevalence and distribution of these protozoan cysts in local water resources.
Cryptosporidium ; Cryptosporidium parvum ; Diarrhea ; Drinking ; Drinking Water ; Gastroenteritis ; Giardia ; Giardia lamblia ; Lakes ; Naegleria fowleri ; Oocysts ; Prevalence ; Recreation ; Rivers ; Swimming Pools ; Water Resources ; Water

Chronic heart failure (CHF), a clinical syndrome resulting from the consequences of various cardiovascular diseases (CVDs), is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group (city) and the forest bathing group (forest). After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs.
Aged ; Chronic Disease ; Complementary Therapies ; methods ; Forests ; Heart Failure ; blood ; drug therapy ; therapy ; Heart Function Tests ; Humans ; Interleukin-6 ; blood ; Natriuretic Peptide, Brain ; blood ; Oxidative Stress ; Recreation ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.
Dental Occlusion* ; Dental Porcelain ; Diagnosis ; Follow-Up Studies ; Humans ; Maxilla ; Mortuary Practice ; Mouth Rehabilitation ; Prostheses and Implants* ; Recreation ; Tooth ; Tooth Attrition ; Tooth Loss

We examined community-level characteristics associated with free drinking water access policies in U.S. municipalities using data from a nationally representative survey of city managers/officials from 2,029 local governments in 2014. Outcomes were 4 free drinking water access policies. Explanatory measures were population size, rural/urban status, census region, poverty prevalence, education, and racial/ethnic composition. We used multivariable logistic regression to test differences and presented only significant findings. Many (56.3%) local governments had at least one community plan with a written objective to provide free drinking water in outdoor areas; municipalities in the Northeast and South regions and municipalities with ≤ 50% of non-Hispanic whites were less likely and municipalities with larger population size were more likely to have a plan. About 59% had polices/budget provisions for free drinking water in parks/outdoor recreation areas; municipalities in the Northeast and South regions were less likely and municipalities with larger population size were more likely to have it. Only 9.3% provided development incentives for placing drinking fountains in outdoor, publicly accessible areas; municipalities with larger population size were more likely to have it. Only 7.7% had a municipal plumbing code with a drinking fountain standard that differed from the statewide plumbing code; municipalities with a lower proportion of non-Hispanic whites were more likely to have it. In conclusion, over half of municipalities had written plans or a provision for providing free drinking water in parks, but providing development incentives or having a local plumbing code provision were rare.
Censuses ; Drinking Water* ; Drinking* ; Education ; Logistic Models ; Motivation ; Population Density ; Poverty ; Prevalence ; Recreation ; Sanitary Engineering

Objective: To study the characteristics of social relations and relative factors among MSM in Guangzhou. Methods: Data was collected through a cross-sectional study in Guangzhou from November 2016 to May 2017. Sample size was estimated and participants were recruited from the voluntary counseling and testing services (VCT) which were set for MSM population, by nongovernmental organizations (NGOs) and the Centers for Disease Control and Prevention (CDC). Social ties and demographic characteristics of the respondents and their sexual partners were analyzed through both Chi square test and generalized estimating equations (GEE). Results: A total of 1 073 MSM, together with their nominated 4 301 partners were successfully recruited and involved in this study. Age (OR=1.2, P=0.01) and non-internet based intercourse (OR=1.65, P<0.01) were easy to form close relation with strong ties. Compared with MSM traditional venues (chess and cards room, tea room bathhouse, club), general public venue (bars, KTV, parks, shopping malls, schools, restaurants) (OR=1.46-3.12, P<0.01) showed close relation with strong ties. Our finding showed that MSM at the age of 18-25 preferred to build weak ties with the older MSM, while the 26-30-year-olds and 31-40-year-olds prefer to establish weak ties with younger partners but the 41-50-year-olds preferred to develop weak ties with one that were ten years younger. Conclusions: Clusters were noticed in the MSM populations when grouping and making friends with ones at different age. Characteristics regarding the relationship between sexual partners in choosing venues and ways of dating were different. Targeted intervention programs need to be explored innovatively.
Coitus ; Cross-Sectional Studies ; Homosexuality, Male/psychology* ; Humans ; Interpersonal Relations ; Male ; Middle Aged ; Recreation ; Risk-Taking ; Schools ; Sexual Behavior ; Sexual Partners ; Social Behavior ; Surveys and Questionnaires

OBJECTIVETo understand the epidemiologic characteristics of fall in people aged ≥60 years in China and provide evidence for the development of prevention and control measures of fall in old population.

METHODSData of fall in people aged ≥60 years in China in 2014 were collected from National Injury Surveillance System (NISS) for the descriptive epidemiologic analysis.

RESULTSA total of 41,073 fall cases were reported in people aged ≥60 years in 2014, accounting for 52.81% of total unintentional injuries in this population. The fall to unintentional injury ratio was higher in older age group. The gender ratio of fall cases was 0.77 and the proportion of females increased with age. Fall mainly occurred during 8:00-11:59 in the morning (33.31%). The top three places where fall might occur were home (55.66%), public residential places (20.52%) and roads (11.64%). Recreational activity (68.94%) and housework/study (16.14%) were the major causes for fall. The common injury sites were low limbs (29.28%), head (24.40%) and body (20.04%), while the common injuries caused by fall were bruise (45.76%) and fractures (29.52%), spain/strain (13.28%). The fall injuries were mainly mild (64.20%), while more moderate and serious fall injuries occurred in older age group.

CONCLUSIONFall is the major cause of injury in old population in China, and the proportion of fall in unintentional injury in this population increased with age, indicating that the prevention of fall in old population should be strengthened.

Accidental Falls ; statistics & numerical data ; Aged ; Aged, 80 and over ; China ; Environment ; Female ; Humans ; Male ; Middle Aged ; Recreation ; Residence Characteristics

OBJECTIVETo understand the epidemiological characteristics of head injuries in children.

METHODSData was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age.

RESULTSA total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%).

CONCLUSIONSIn 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Asian Continental Ancestry Group ; statistics & numerical data ; Automobile Driving ; Child ; China ; epidemiology ; Craniocerebral Trauma ; epidemiology ; Environment ; Female ; Humans ; Male ; Population Surveillance ; Recreation ; Sports ; Transportation ; Wounds and Injuries ; epidemiology

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease (COPD). The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states (POMS) evaluation were performed. In the forest group, we found a significant decrease of perforin and granzyme B expressions, accompanied by decreased levels of pro-inflammatory cytokines and stress hormones. Meanwhile, the scores in the negative subscales of POMS decreased after forest bathing trip. These results indicate that forest bathing trip has health effect on elderly COPD patients by reducing inflammation and stress level.
Aged ; Cytokines ; genetics ; metabolism ; Female ; Forests ; Gene Expression Regulation ; physiology ; Humans ; Lymphocyte Subsets ; physiology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; pathology ; psychology ; therapy ; Recreation

BACKGROUND: It is important to educate families of pediatric patients with atopic dermatitis (AD) so that they have a correct understanding of AD. OBJECTIVE: The purpose of this study is to introduce, evaluate, and improve our family-engaged educational program. METHODS: Children suffering from AD and their families have participated in a half-day educational program called "AD school" with catchy slogans such as "Enjoy with AD Families!" every year since 2005. Educational lectures were conducted for parents. For children with AD, various entertaining programs were provided. A feedback survey about AD school was administered for the purpose of evaluation. RESULTS: A total of 827 people (376 patients and 451 family members) participated in this program over 7 years. On-site surveys showed a positive response (i.e., "excellent" or "good") for the prick test (95.1%), emollient education (78.4%), educational lecture (97.0%), drawing contest and games (90.2%), and recreation (magic show; 99.0%) respectively. Telephone surveys one year later also elicited a positive response. CONCLUSION: We herein introduce the experience of a half-day, family-engaged educational program for AD. Family-engaged education programs for AD such as this AD school encourage and validate family participation in the treatment of their children's AD.
Child ; Dermatitis, Atopic* ; Education ; Humans ; Korea* ; Lectures ; Parents ; Recreation ; Telephone