Environmental Transmission of Noroviruses and Study of Fecal Microorgnisms as Viral Indicators in the Suyeong River in Busan, Korea

In order to investigate the occurrence of norovirus in rivers and beaches, a total of 81 samples were tested at seven sites of Oncheon stream, Suyeong river and Gwanganri beach in Busan from January to November, 2017. To improve the detection of norovirus from sea water, we applied the inorganic cation-coated filter method which showed 48.8% ± 12.2% (n=3) and 27.4% ± 6.0% (n=3) recovery yields from river water and sea water inoculated with Norovirus, respectively. Norovirus was detected in a total of four samples (4.9%), which all were GII genotype. Norovirus GII was detected in three samples at two waste water treatment plants (WWTP) outlet and one sample at about 500 meter downstream from WWTP in both the winter and spring seasons. We also monitored fecal indicator organisms, Escherichia coli (E. coli), Enterococcus and coliphages [somatic coliphages (SC), male-specific coliphages (MSC)] to analyze the potential transmission of enteritis causative agent in dry and wet days. Bacterial influences were found at the site of the WWTP effluents in the dry days and spread further to the costal beach in the wet days. But no viral influences were found in the river downstream in both dry and wet days.

Empowerment and Job Satisfaction among Clinical Nurses in South Korea: Systematic Review / 간호행정학회지

PURPOSE: To synthesize and identify the studies that delineated the relationship between empowerment and job satisfaction in clinical nurses in Korea. METHODS: Electronic databases were searched, including KmBase, KoreaMed. riss4u, National Assembly Digital Library and National Discovery for Science Leaders (NDSL) The search terms included nurse, satisfaction and empowerment. Only papers published in Korean were included. RESULTS: Twelve studies, from 156 references screened, were included the final analysis. All studies were non-experimental and used correlational analysis. A significant positive relationship between structural or psychological empowerment and job satisfaction was found. Older nurses with longer clinical experience and higher education background were more likely to have high level of structural and psychological empowerment and job satisfaction. CONCLUSION: The study results indicate that to produce an empowering work environment, nurse managers have to create a supportive organizational culture, and provide access to resources and opportunity as well as to strengthen emotional support.

An Analysis of the Correlation between Alopecia and Chief Complaints / 대한의료정보학회지

OBJECTIVES: In this study, we measured the extent of ten levels of classified symptoms by 300 (male and female) patients visiting the hair loss clinics of "S" hospitals in Gangbuk and Gangnam between January 2009 and June 2011 by analyzing the patients' chief complaints. METHODS: The method of measurement was based on a symptom questionnaire possessing 51 categories. Through the statistical analysis of data mining techniques, decision trees, and logistic regression, we derived a logistic regression model and decision tree model that improved both the response rate and significant hair loss-related characteristics of the questionnaire. RESULTS: The results of this study indicate that dry hair, seborrheic scalps and skin, tobacco and/or coffee addiction, anxiety, nausea, indigestion, and facial flushing correlate to hair loss. CONCLUSIONS: We anticipate that the subjective symptoms of hair loss can provide a foundation for preventing secondary diseases and provide clinical data information during the period of treatment. This can contribute to the improvement of patient satisfaction after customized treatment.

A case of pelvic retroperitoneal benign schwannoma presenting as a gynecologic malignancy with pulmonary thromboembolism / 대한산부인과학회지

Retroperitoneal schwannomas are rare tumors difficult to diagnose preoperatively. It may originate at the cranial nerves or nerves of the upper extremities, but origin along the nerves of the retroperitoneal space is very rare. Most of the retroperitoneal schwannomas are benign neoplasm. These tumor can be misdiagnosed as adnexal mass or carcinoma. Venous thromboembolism or pulmonary embolism is increasingly recognized as a common complication in patients with malignant disease. We report a 37-year-old woman presented with pulmonary thromboembolism and a pelvic mass which was incidentally found and misdiagnosed as ovarian cancer. Histopathologic results of the extirpated mass turned out to be a benign schwannoma.

A Case of Preeclampsia Complicating a Pregnancy with Malignant Neurofibromatosis / 대한주산의학회잡지

Neurofibromatosis type 1 (NF-1) is one of the most common genetic disorders, occurring once in every 4000 births. The prevalence of neurofibromatosis associated with pregnancy was one in 5000~18500 deliveries. Higher rates of maternal and neonatal complications have been reported in NF-1 patients including as hypertension, intrauterine growth restriction (IUGR), preterm labor, stillbirth and cesarean section rates. Thus, pregnant patients with NF-1 are required close antenatal observation at high risk tertiary centers in order to detect complication early. We report a case of malignant neurofibromatosis associated with pregnancy with a review of literature.

Influence of stress on snack consumption in middle school girls

Stress has been known to change dietary behaviors and food intakes in individuals. The purpose of this study was to investigate the effect of stress level on the frequency and the amount of snack consumption. The high stress group (HS) showed significantly higher frequency of consumption for bread, chips, cookies, ramyeon, and frozen snacks (p<0.05) compared to low stress group (LS) with higher frequency of snack consumption (p<0.01), and increased intakes of energy, carbohydrates, and sodium from snacks (p<0.01) than LS. As the stress level became higher, the proportions of students with irregular meals, overeating, and night snacking increased (p<0.01). Also, 33.0% of the subjects answered that they consumed an increased amount of snacks when they were feeling stressed. Our results indicated that stress has negative influence on snack consumption in middle school girls.

A Study of Clinical Manifestations of Acute Rheumatic Fever

PURPOSE: In developed countries, acute rheumatic fever appears to be a vanishing disease. In Korea, the incidence and severity of acute rheumatic fever (ARF) has significantly decreased in recent 30 years. According to this report, Korea sustained low incidence of ARF. METHODS: The medical records of 5 children diagnosed as ARF from January 2000 to September 2006 were reviewed retrospectively about clinical manifestations and laboratory findings. RESULTS: The average incidence of rheumatic fever was 0.17 per annual pediatric in-ward 1,000 patients. During study period, only 1 case had a definite history of preceding infection. Among 5 patients, the incidence of major manifestations were as follows:carditis 5 cases, chorea 1 case, arthritis 1 case and erythema marginatum 2 cases. Clinical findings of carditis were cardiac murmur, cardiomegly, congestive heart failure and pericardial effusion. Significant valvular lesions were mitral and aortic insufficiency. Minor manifestations and other clinical manifestations were fever, arthralgia, dyspnea, coughing, palpitation, weakness and chest pain. Laboratory findings were increased antistreptolysin O titer, positive C reactive protein (CRP) and increased erythrocyte sedimentation rate (ESR). CONCLUSION: The incidence of ARF has reduced but rheumatic carditis varies in severity from moderate to severe cardiac involvement. For many reasons ARF is being diagnosed inappropriately resulting from lack of awareness about the disease due to rarity and secondary prophylaxis. We should be aware of acute rheumatic fever and should pay attention to the treatment of the patients with streptococcal pharyngitis.

A Demonhstration of a Tracheal Bronchus by Bronchoscopy and Computed Tompgraphy

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. It; incidence ranges between 0.1 and 5%. This anomaly is usually diagnosed incidentally during bronchoscopy, bronchography or computed tomography. Occasionally, it represents the underlying etiology for chronic pulmonary disease, especially if it involves the right upper lobe and reflects an abnorrnal pulmonary clearing mechanism. The tracheal bronchus may be associated with other bronchopulmonary anomalies, tracheal stenosis, or Down's syndrome. Asymptornatic tracheal bronchus does not require any treatment. In case of tracheal bronchus associated recurrent right upper lobe diseases, tracheal bronchus therapy should include resection of the aberrant bronchus as well as the lob it supplies. (J Korgan Pediatr Soc 2000;43:1501-1504)

A Case of Citrullinemia Controlled by Diet and Arginine

Citrullinemia is an inborn error of urea cycle metabolism caused by deficiency of arginosuccinate synthetase. It is characterized by hyperammonemia and high citrulline level in serum, CSF and urine. The clinical symptoms include vomiting, lethargy, seizure, coma and ultimately death if hyperammonemia is not controlled. We report a case of 9- day old male with citrullinemia who was initially treated with sodium benzoate during acute stage followed by gradual weaning to discontinuation. Hyperammonemia was well controlled by low protein milk diet and arginine.

Bone Mineral Metabolism and Rickets Compared between Fortified Human Milk and Preterm Formula Feeding in Prematurity

PURPOSE: To compare the effect of breast milk containing fortifier with preterm formula on bone mineral metabolism in premature infants, we evaluated the state of bone mineralization, biochemical alteration and the frequency of rickets during the first five months of life. METHODS: Fourteen fortified breast milk-fed infants and eleven preterm formula-fed infants who were born at Il-Sin Christian Hospital from August, 1996 through July, 1997, were studied. The breast milk-fed group received human milk fortifier. The intake of Ca, P, Mg, protein, and fat was calculated at one month of age. Birth weight and weight at one, two and five months of age were measured. Serum Ca, P, alkaline phosphatase and 25-hydroxyvitamine D were measured at one month of age, and the wrist received X-ray examinations monthly. Total body bone mineral content was measured by Dual energy X-ray absorptiometry (Lunar WI) at two and five months of age. RESULTS: The two groups were similar in birth weight, gestational age, and weight at one, two and five months of age. Enteral Ca, P, protein, Mg, and fat intake, and urinary excretion of Ca, P were similar among the two groups. Serum Ca, P, ALP and 25-hydroxyvitamin D were not different. Occurrence of rickets and bone mineral content were similar among the two groups. CONCLUSION: Fortified breast milk-fed infants and preterm formula-fed infants showed no difference in total body bone mineral content and occurrence of rickets. Ultimately, we could enhance the advantage of breast milk fed to premature infants by adding fortifier.

Clinical Study of Neonatal Systemic Fungal Infection

PURPOSE: We evaluared the risk factors, clinical characteristic, diagnosis and treatment of neonatal systemic fungal infection in 28 cases in order to find ways to prevent development of and to improve the prognosis of neonatal systemic fungal infection METHODS: From November 1994 to August 1996, 28 premature infants who were diagnosed as systemic fungal infection at Ilsin Christian Hospital NICU were analyzed retrospectively. RESULTS: 1) The mean gestational age was 30.7 weeks(27-35.5weeks) and the mean birth weight was 1528g(975-2980g). 2) The risk factors associated with the development of neonatal systemic fungal infection included long-term use of broad-spectrum antibiotics, prolonged hyperalimentation, prolonged use of aminophylline and steroid, and endotracheal intubation. 3) The most common presenting clinical manifestations were temperature instability, feeding intolerance, and apnea. 4) In laboratory studies, blood, urine, and CSF culture positivity was 92.8%, 92.8%, and 10.7%, respectively and renal and cranial sonogram were helpful to evaluate the renal and CNS involvement. 5) The principal treatment was intravenous amphotericin B administration for 4 weeks. The side effects, such as renal toxicity, hepatotoxicity, hypokalemia, and vomiting, developed but were reversible. 6) The mortality rate was 7.1%, and ventriculo-peritoneal shunts was performed in 3 cases who had fungal meningitis for the management of postmeningitic hydrocephalus. CONCLUSION: For was beformedin the diagnosis of neonatal systemic fungal infection is very difficult and the mortality is high, we recommend that antifungal therapy be initiated in clinically ill infants who are not responsive to antibiotic therapy and have negative culture findings and have some of the risk factors associated with systemic fungal infection.