PURPOSE: This study was to analyse the factors affecting youth smoking, especially self-efficacy and perceived social norm, based on the stage of change. METHODS: A self-reported survey was conducted during the period from the 21st of April to the 17th of May, 2008. Data were collected from 10,707 students of 12 middle schools in Seoul, Gyeonggi-do, and Incheon. The data were analysed with SPSS/WIN 15.0. RESULT: The smoking possibility was 2.18 times higher in the male students than in female students, and 1.76 times higher in 8th-grade students and 2.48 times higher in 9th-grade students than in 7th-grade ones. Smoking possibility increased when students had more experience in alcohol, more friends who smoke, or worse relationship with their parents. Also this study showed that high-level self-efficacy and perceived social norm were acting as inhibiting factors of smoking. CONCLUSION: To reduce the youth's smoking rate, smoking prevention programs should provide educational chances to learn knowledge and skills on how to reject smoking temptation. Also, someone significant like parents should make it clear to the youth that they do not want their children to smoke.
Adolescent* ; Child ; Female ; Friends ; Gyeonggi-do ; Humans ; Incheon ; Male ; Parents ; Seoul ; Smoke* ; Smoking*

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. isolates are clinically resistant to all the beta-lactams except for carbapenems. The most important task facing clinical microbiologists today is the reliable detection of ESBL-producing microorganisms. There is currently a little reliable methods designed specifically for the detection of ESBLs in isolates of E. coli and Klebsiella spp. that can be performed easily in a clinical laboratory. This study was designed to evaluate the ability of the Vitek GNS 121 card to detect the ESBL-producing E. coli and Klebsiella spp. METHODS: One hundred and twenty-two isolates of E. coli, 141 of K. pneumoniae, and 3 of K. oxytoca from patients of the Kosin Medical Center, Pusan, Korea were tested. Antimicrobial susceptibilities were tested by the disk diffusion method. And the double disk synergy (DDS) test and the Vitek GNS 121 card determined the ESBL-production. RESULTS: Among the 135 DDS-positive isolates (K. peumoniae, 104; E. coli, 28; K. oxytoca, 3), 131 isolates (K. pneumoniae, 103; E. coli, 25; K. oxytoca, 3) showed positive results with the Vitek GNS 121 card as well. And all the isolates of K. pneumoniae (37) and E. coli (94) showed negative results with both the DDS test and the Vitek GNS 121 card except for 1 isolate of E. coli. The Vitek GNS 121 card showed 97% ESBL detection-sensitivity, 99% specificity and 99% positive predictive value. Three isolates of E. coli and 1 of K. pneumoniae resistant to cefoxitin showed positive results with the DDS test but showed negative results with the Vitek GNS 121 card. CONCLUSIONS: The Vitek GNS 121 card seems to be adequate for routine use in the detection of ESBL-producing isolates of E. coli and Klebsiella in clinical microbiology laboratories. Also, additional evaluation should be taking place on its detection ability for other members of the ESBL-producing Enterobacteriaceae.
beta-Lactamases ; beta-Lactams ; Busan ; Carbapenems ; Cefoxitin ; Diffusion ; Enterobacteriaceae ; Escherichia coli* ; Escherichia* ; Humans ; Klebsiella* ; Korea ; Pneumonia ; Sensitivity and Specificity

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.
Anti-Infective Agents ; Colon ; DNA ; DNA Fingerprinting ; Epidemiologic Studies* ; Genotype ; Humans ; Pyuria ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.
Anti-Infective Agents ; Colon ; DNA ; DNA Fingerprinting ; Epidemiologic Studies* ; Genotype ; Humans ; Pyuria ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Spitz nevus and malignant melanoma have common features clinically and histologically, and in some cases it is impossible to distinguish between the two. Heat shock proteins (HSPs) serve to protect cells, and are activated by cell injury. Some HSPs are shown to be elevated in many types of cancers. Previous studies have reported the expression of heat shock protein in association with melanoma; however, a similar relationship with Spitz nevi has never been investigated. OBJECTIVE: This study was designed to measure the expression pattern of HSP 105 in both Spitz nevi and melanomas. METHODS: The specimens of 4 of Spitz nevi and 10 of malignant melanomas were analyzed for heat shock protein 105 expression through immunohistochemical staining. RESULTS: Immunohistochemical examination of HSP 105 showed strong expression in malignant melanoma specimens. On the other hand, weak expression was observed in Spitz nevus specimens. The degree of expression of HSP 105 showed a statistically significant difference (p<0.05). CONCLUSION: These findings provide the possibility of using HSP 105 as a effective marker for differentiating between Spitz nevi and malignant melanomas. In support of this, HSP 105 is considered to be a tumor-associated antigen of malignant melanoma.
Hand ; Heat-Shock Proteins ; Melanoma ; Nevus ; Nevus, Epithelioid and Spindle Cell

PURPOSE: Because the main drawback of bilateral adrenalectomy is permanent adrenal insufficiency and the subsequent risks of life-long steroid use, adrenal preserving partial adrenalectomy is being accepted as its alternative. The aim of this study is to investigate the indications for bilateral adrenalectomy and to assess the postoperative outcomes and steroid replacement according to operative methods. METHODS: From May 1996 through July 2013, a total of 25 patients who underwent bilateral adrenalectomy in our institution were reviewed retrospectively. Surgical outcomes were compared between total and partial adrenalectomy, and postoperative steroid hormone replacement were examined according to the volume of remnant adrenal gland. RESULTS: The median follow-up duration of 25 patients was 55.8 months. The most common indication for bilateral adrenalectomy was bilateral pheochromocytoma (n=16), which was associated with genetic mutation of RET or VHL gene in 11 cases. Cushing's syndrome (n=8) and hyperaldosteronism (n=1) were another indications of bilateral adrenalectomy. Total adrenalectomy was performed in 8 patients and adrenal preserving partial adrenalectomy in 17 patients. Among the 17 patients, only 5 patients needed adrenal hormone replacement and 2 patients had a recurrence at remnant adrenal tissue. CONCLUSION: Adrenal preserving partial adrenalectomy might be a better option for bilateral adrenal tumor than total adrenalectomy because it can reduce complications associated with adrenal insufficiency and recurrence of the disease is not common.
Adrenal Glands ; Adrenal Insufficiency ; Adrenalectomy* ; Cushing Syndrome ; Follow-Up Studies ; Humans ; Hyperaldosteronism ; Pheochromocytoma ; Recurrence ; Retrospective Studies

OBJECTIVES: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). METHODS: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). RESULTS: 70 individuals with ASD (63 males, 87.94+/-37.8months), 53 SIB (27 males, 85.40+/-48.06 months), and 32 TC (19 males, 104.19+/-23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age (chi2=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination (chi2=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. CONCLUSION: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.
Aged ; Appointments and Schedules ; Autistic Disorder ; Caregivers ; Child ; Autism Spectrum Disorder ; Fertilization ; Gestational Age ; Humans ; Male ; Parturition ; Siblings ; Vaccination

Extramedullary plasmacytomas most commonly occur in the nasal cavity, nasopharynx, paranasal sinuses, and larynx. Solitary extramedullary plasmacytoma (SEP) of the thyroid gland is rare. The diagnosis of SEP of the thyroid by cytology is typically difficult before surgery, and the entity is often confused with different cytology findings. We report a case of a 59-year-old man with primary plasmacytoma of the thyroid presented as a rapidly enlarging thyroid gland with Hashimoto's thyroiditis. He had been suffering from anterior neck swelling for 1 month. Several fine-needle aspiration biopsies yielded Hashimoto's thyroiditis. During a follow-up period of 3 years, the size of the thyroid gland increased and a mass lesion in right thyroid gland was detected. A total thyroidectomy was performed based on a diagnosis of a thyroid tumor with Hashimoto's thyroiditis. Permanent pathology identified the mass as an extramedullary plasmacytoma associated with Hashimoto's thyroiditis. Skeletal survey and serum electrophoresis tests were normal, and a bone marrow biopsy yielded no evidence of multiple myeloma. The patient underwent definitive radiotherapy and remained free from any recurrences during follow-up.
Biopsy ; Biopsy, Fine-Needle ; Bone Marrow ; Electrophoresis ; Follow-Up Studies ; Hashimoto Disease ; Humans ; Larynx ; Middle Aged ; Multiple Myeloma ; Nasal Cavity ; Nasopharynx ; Neck ; Paranasal Sinuses ; Plasmacytoma ; Recurrence ; Stress, Psychological ; Thyroid Gland ; Thyroidectomy ; Thyroiditis

BACKGROUND: Intraventricular conduction disturbances, as manifested by increased QRS duration, are common in patients with advanced left ventricular (LV) dysfunction and adversely affect LV systolic and diastolic function. It has been reported that the patients with prolonged paced QRS duration have more serious heart disease, and the paced QRS duration can be a useful indicator of impaired LV function. Hemodynamic effects of paced QRS duration and pacing site during right ventricular (RV) pacing are unknown. METHODS: A total of 14 patients who underwent electrophysiologic study for paroxysmal supraventricular tachycardia at Chonnam National University Hospital were examined. All the patients had no structural heart disease. RV pacing was performed at 10 different sites with cycle length of 600 ms and 500 ms using a 6-7F deflectable quadripolar electrode catheter (Livewire, St. Jude Medical, Minneapolis, MN, USA). Systolic, diastolic, and mean blood pressures were measured after stabilization of blood pressure during pacing. RESULTS: Blood pressures (systolic/diastolic/mean) decreased from 146 +/- 31/95 +/- 28/125 +/- 23 mmHg to 128 +/- 33/80 +/- 25/107 +/- 20 mmHg, respectively. The change of QRS duration during pacing and the systolic blood pressure (SBP) before pacing were higher in the group with paced QRS duration greater than 140 msec (59.1 +/- 13.6 msec vs 84.9 +/- 18.7 msec, 141 +/- 30 mmHg vs 152 +/- 38 mmHg, p<0.001, p=0.011, respectively). The decrease of SBP during pacing was higher in the group with paced QRS duration greater than 140 msec (13 +/- 11 mmHg vs 24 +/- 14 mmHg, p=0.009). The decrease of SBP during pacing was related with QRS duration during pacing (r=0.500, p=0.001), the change of QRS duration during pacing (r=0.426, p=0.001), and SBP during sinus rhythm (r=0.342, p=0.001) on linear correlation analysis. Pacing site, however, did not affect acute hemodynamic change during pacing. The independent factors associated with the decrease of SBP during pacing were SBP before pacing and QRS duration during pacing. CONCLUSION: We concluded that acute deleterious hemodynamic effects of RV pacing are related with paced QRS duration but not with pacing site. Ventricuar pacing at the area of paced QRS duration less than 140 msec is recommended particularly in high risk patients.
Blood Pressure ; Catheters ; Electrodes ; Heart Diseases ; Hemodynamics* ; Humans ; Jeollanam-do ; Tachycardia, Supraventricular