Eom, Seok Hyeon;Park, Chang Hwan;Chung, Duk Won;Lee, Sang Hyeok;Seo, Ji Young;Kim, Yeong Sung;Kwak, Dong Hyup;Kim, Jung Hee
Journal of Yeungnam Medical Science
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v.33
no.2
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pp.146-149
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2016
Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.
Objectives : To investigate the prevalence of Clonorchis Sinensis infestation and to determine the associated risk factors among a population in a part of the rural area of Gyeongsangnam-do, Korea, which is an area known to have a high mortality from liver cancer and a high infection of C. sinensis. Methods : The study populat ion consisted of those people who have lived in rural areas and who were over 40 years old. This study was performed in 5 areas during the period from 1999 to 200 3. Informed consents were obtained from the 2,381 study participants, and these people were interviewed about their life style habits with using the structured questionnaire that was administered by trained staff members. The subjects underwent blood sampling and their stool specimens were examined by using the Formalin-ether sedimentation technique. Results : Among the study subjects (N=2,381), the positivity for C. sinensis in the stool was 34.4% (95% CI=36.3-42.5); it was 39.4% (95% CI=36.3-42.5) in the males and 30.9% (95% CI=28.5-33.3) in the females . The positivity for C. sinensis was associated with current alcohol drinking (odds ratio=1.8, 95% CI: 1.5-2.1) and raw fish consumption (odds ratio 1.2, 95% CI: 0.9-1.6). Conclusion : The present study confirmed the high prevalence of C. sinensis in the study subjects. It is necessary to establish consistent medical management and education programs for the treatment and prevention of C. sinensis infestation in the rural inhabitants of Korea.
Joo, Kyoung-Hwan;Chu, Paul B.;Rim, Han-Jong;Lee, Joon-Sang
Journal of agricultural medicine and community health
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v.12
no.1
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pp.80-93
/
1987
Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.
Journal of agricultural medicine and community health
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v.22
no.2
/
pp.239-252
/
1997
A questionnaire survey including stool examination for the parasite ova, skin test, and enzyme-linked immunosorbent assay (ELISA) of the liver fluke to find the factors related with the prevalence of the parasite infestation was done toward 118 residents living in three villages of Song-jung, Yi-jung, and Chim-gok of Okok-myun, Goksung County, South Cholla Province. The results are as follows : 1. The prevalence of Clonorchis sinensis ova by the stool examination was 46.6%. The sensitivity and specificity of skin test to egg-positive cases were 63.5% and 68.9%. The sensitivity and specificity of ELISA to egg-positive clonorchiasis were 100% and 34.9%. 2. The prevalence of Clonchiasis was higher in male than in female. 45~64 year old group was the highest among age groups, and the longer the duration of living in the present residence was, the higher the prevalence was shown statistically significantly (p<0.01). 3. The present drinker had higher prevalence of Clonorchiasis significantly than the past drinker or non-drinker, and the more the frequency of drinking the higher the prevalence was shown significantly (p<0.05). 4. Those who took raw fish had significantly higher than persons who didn't take it or take cooked fish(p<0.05) and prevalence showed the tendency to be increased as the frequency to take raw fishes increased significantly(p<0.05). 5. Those who had taken a raw sweet fish(Plecoglossus altivelis) or snake-headed fish(Ophicephalus argus) showed significantly higher prevalence of infection with liver fluke than persons who didn't take the raw fish. 6. While 56.4% of persons infected with Clonorchiasis answered that they were healthy, only 13.0% of the subjects were careful for their health, and 41.8% experienced tests to diagnose liver flukes before they were examined by this survey. 7. While 56.4% of infected persons thought the prevalence was high in their community, 54.0% were afraid to be infected, 47.1% thought the infection might destroy their health, 25.5% took treatment drugs, and 18.2% took raw fish continuously after treatment. The above results confirmed that Goksung area was highly prevalent in Clonorchiasis, so it was necessary to push effective preventive program against liver fluke infection together with the program to diagnose and treat existing infected persons.
This study was done to develop self - directed learning modules related to asepsis and elimination including urine and stool for Fundamentals in Nursing practice education contents and to measure the effectiveness of those modules. The subjects of this study were 96 sophomore students in the nursing college. Self-directed learning modules were developed by the researcher on the basis of the Lippincott Learning System of Kruger (1986) and Modules for Basic Nursing Care of Ellis (1992). Videotape was editted by using videotape made by the Lippincott Company and Film strip made by the Trainex Company with Korean dubbing. Self-directed learning was done for one week with the asepsis module and two weeks with the elimination modules after confirming the requiered level of knowledge acquisition through pre-test. For measuring proficiency in self-directed learning, a written test for cognitive domain, a sufficiency test for psychomotor domain, and a confidnece examination for affective domain were given. The data were analyzed using descritive statistics, and Pearson correlation coefficient using a SPSS-PC program. The results are summarized as follows: 1. Sufficiency test and confidence examination grades showed high levels in both asepsis and elimination. 2. Written test grades showed a high level in asepsis and elimination of urine but showed a medium level in eliminationin of stool. 3. Grades of sufficiency and confidence in asepsis and elimination practice were statistically significant with a moderate positive correlation (r=0.4- 0.5, p<0.001). 4. Grades of sufficiency and written tests in asepsis and elimination practice also were statistically significant with a moderate positive correlation (r=0.5-0.7, p<0.001). 5. Students showed relatively high contentment with the self-directed learning modules themselves but revealed relatively low contentment with video program and the self-directed learning process. In conclusion, this study disclosed that proficiency levels in cognitive, affective, and psychomotor domains were high when asepsis and elimination modules were applied. Also students showed high satisfaction with the modules themselves, but didn't show high contentment with the video programs. In considering low contentment with the self-directed learning process, it is estimated the students had experienced some difficulties about using self-directed learning modules because this was their first exposure to the self-directed learning module and they were already accustomed to the demonstration-practice method.
Studies were conducted from May, 1993 to April, 1995 to determine the changing patterns of infection Ity the liver fluke, Clonorchis sinensis, among residents and fish hosts in Kyongbuk Province. The infection rate among residents was 7.7% by stool examination. The rate in males (11.3%) was significantly higher than females (4.1%) Positive rate of intradermal test was 27.6% in the same population. The special type of a simple catalytic model was applied for the analysis of intradermal positive reactors by age arid sex, ann the equation was Y= 0.4776 t (1 -e-0.0375t) for mates ann, y : 0.2085 (1-e-0.0138t) for females. Analysis of stool examination data by two-stage catalytic model revealed y : 0.025 (e-0.0047t _ e-0.0235t). The annual Clonorchis infection rate was 4.7 per 1,000 susceptibles and the annual loss rate was 23.5 per 1,000 infected. The frequency distribution by the eggs per gram (EPG) was calculated as well as the cumulative percentages of positives. The regression equations were y : 0.929+ 1.506 log x for males and, y : 0.473 + 1.767 log x for females. Of the 25 fish species, 7 species were infected with Clonorchis mrtacercariae. Infection rates varied by the species, and ranged from 2.8% in Punfun,Bia herzi to 30.0% in Pseudorasbora panic. Average number of the matacercariae per gram of flesh was 58.1 in p. pnnpa, followed by 10.2 in Gncthopogon atromoculntus, 7.0 in Saurosobio dobryj, and 3.0 in Pcrccheilogncthus rhonlben. The present study indicates that clonorchiasis in Kyongbuk Province is less prevalent than that of several decades ago.
A 9-month-old female Korean short hair cat weighing 2.2 kg presented for evaluation of a two-week history of obstipation. The owner reported that the cat sustained pelvic fractures 4 months previous to the onset of fecal tenesmus. On physical examination, fecal tenesmus was observed and restriction of the movement of the right coxofemoral joint was evident. Rectal palpation revealed narrowing of the pelvic canal with a hard bony protuberance at the bilateral acetabulum and pubic bones. Radiographs revealed a distended colon with feces and narrowing of the pelvic canal with abnormal structure of the pelvic bone. Conservative management consisting of stool softeners and a warm water enema was instituted; however, there was no improvement in obstipation. Partial iliac, ischial, pubic, and acetabular ostectomies were performed. Postoperative radiographs and rectal palpation revealed the enlarged pelvic canal. Stool softeners (5 ml orally twice daily) was administered following surgery for 14 days and then tapered down to 2.5 ml for 14 days. A warm water enema was performed twice postoperatively. At examination 14 days postoperatively, no problems with defecation and gait were reported. There was no evidence of obstipation and lameness of the left pelvic limb 5 months postoperatively.
A total of 197 fecal specimens was prepared for quantitative examination of helminth eggs by modified Kato's cellophane thick smear (M.C.T.S.) and Stoll's dilution egg counting technique (D.E,C.T.). The comparative effectiveness of two techniques was evaluated and conversion function was deduced. The average time required for the microscopic examination on one slide by M.C.T.S. was 12.6 minutes and that of D.E.C.T. was 14.6 minutes. M.C.T.S. showed lower false negative rate than D.E.C.T in light worm burden cases. Functions to convert the counts obtained by M.C.T.S. to E.P.G. by Stoll's dilution egg counting technique were $47.86{\times}10^{0.87{\;}logM.C.T.S.},{\;}$ in A. lumbricoides, $41.69{\times}10^{0.82{\;}logM.C.T.S.}$ in T. trichiura and $63.10{\times}10^{0.85{\;}logM.C.T.S.}$ in C. sinensis. It was suggested M.C.T.S. be better than D.E.C.T. for the quantitative examination of intestinal helminthiases such as A. lumbricoides, T. trichiura, and C. sinensis infections even in the cases with low worm burden.
This study was performed to evaluate diagnostic sensitivity and specificity of sonography on clonorchiasis. During the 9 months from March to November 1994, sonography skin test, stool examination, and medical examination were performed to 609 volunteers of Pohang which is located along the Hyongsan-gang (Rivers and is one of well-known endemic areas of clonorchiasis. The sensitivity of sonography was either 21% if the intrahepatic ducts dilatation was assumed to be the only positive anding or 52% if the periductal echogenicity was also included as one of positive findings. The sensitivity of skin test was 62%. The sensitivity was 46% if the diagnostic criteria were arbitrarily assumed as being positive in skin test and having either sonographic findings. The sonographic finding of fusiform, non-shadowing, weakly echogenic foci in gallbladder or in billiaiy tree indicating the flukes or aggregates of flukes was not obvious in this study. The specificity of sonography was either 95% if the intrahepatic ducts dilatation was assumed to be the only positive finding or 82% if the periductal echogenicity was also included as one of positive findings. The specificity of skin test was 52%. The specificity was 90% if the diagnostic criteria was arbitrarily assumed as being positive in skin test and having either sonographic findings.
As epidemiological parameters of human paragonimiasis, the positive rates of intradermal test and the sputum/stool ekaminations have long been employed in population surveys. However, both the specificity of the intradermal test and the sensitivity of sputumjstool examination have been gradually declined as the endemicity was lowered; thus the gap between above two parameters widened. In such context, the development of a new epidemiologic parameter or tool which makes it possible to accurately discriminate the active paragonimiasis cases was necessary. In the present study, the detection rate of Paragonimus-speclac IgG antibody by micro-ELISA was evaluated as an indicator of epidemiologic status of human paragonimiasis in a population. A total of 4, 285 students and inhabitants living in Bukpyeong Myeon and Bukil Myeon, Haenam Gun, Jeonlanam Do was surveyed in October, 1983 by intradermal test first. Out of them, 244 cases (5.7%) were found positively reacted to VBS antigen of F. westermani. Out of 168 positive reactors, 7 cases (4.2%) were egg positive either by two times of sputum examination or by one stool examination. That indicated that only 0. 16% of total surveyed were confirmed as active paragonimiasis by egg detection. When sera collected from 239 positive reactors of Intradermal test were tested by micro-ELISA for their specific IgG antibody, 40 cases(16.7%) were found to be positive. All of 7 egg positive cases were again positive for specific IgG antibody. Among remaining 232 intradermal test positive cases, 33 cases were positive for IgG antibody. In contrast to those, none of 42 positive reactors to intradermal test for Cloncrchis and of 128 intradermal test negative cases showed positive for Paragcnimus-specIfic IgG antibody. The rate of specific IgG antibody as detected by micro-ELISA appeared to be increased with the wheal size of the intradermal test. When the wheal sixte was over 13mm in diameter, about 50% of them were positive for specific IgG antibody. Thirty-one specific antibody positive cases were clinically evaluated by laboratory examinations (repeated sputum examination, peripheral eosinophil count and chest roentgenogram) and by history taking. Out of them 24 cases were associated with one or more positive laboratory findings: thus considered as active paragonimiasis cases. Out of 7 lab. finding-free cases 3 revealed past history of typical paragonimiasis symptoms, suggesting that they were in chronic or in convalescent stages. The remaining 4 cases were considered as either mild or ectopic infection cases; the possibility of cross-reaction with other helminthiases could not be ruled out. From the above results, it was inferred that the detection of Paragonimus-specIfic IgG antibody by micro-ELISA was very much helpful in detecting the active cases as well as in proper evaluation of the endemicity of human paragonimiasis in a population. The convenience of mass haildling of sera in micro-ELISA was considered another superiority as an epidemiologic tool.
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