OBJECTIVE: This study was performed to determine the smoking status and its associated factors in military life among young Korean men to provide date for smoking prevention in military areas as a part of the health promotion program for soldiers. METHODS: 1,033 infantrymen serving in 17 military units, which are located in suburbs of K city, were enrolled in this study. A questionnaire on the soldiers smoking status and other various characteristics was obtained from October 2nd to 12th, 2000. Logistic regression analysis was performed on the various variables in order to determine the factors related to smoking. RESULTS: 1) 830(80.3%) out of 1033 subjects had smoked cigarettes and 759 persons(73.4%) were regular smokers. 2) Among the 734 soldiers who started smoking before their military service, 714 soldiers(97.2%) continued to smoke after, while 45 soldiers(15.0%) among the 299 non-smokers started smoking after joining the army. 3) Through the logistic regression analysis, the education level, specialty in the army, smoking amongst the friends they met before military service, smoking amongst soldiers in the army, dating girl friends, drinking, satisfaction with their army lives and the presence of convenient smoking places at the barracks were significant factors related to the prevalence of smoking in soldiers. CONCLUSION: the factors related with incidence of smoking in the army are the complicated interactions among the individuals personal background, general charcterisitcs of the solider and the special environment in the barracks. Therefore, to improve national soldiers' health, an active non-smoking campaign and education should be pushed to discourage smoking in the barracks.
Drinking ; Education ; Female ; Friends ; Health Promotion ; Humans ; Incidence ; Logistic Models ; Male ; Military Personnel* ; Prevalence ; Smoke* ; Smoking* ; Tobacco Products

Adult ; Connective Tissue ; Extremities ; Head ; Histiocytoma, Malignant Fibrous ; Humans ; Maxilla ; Neck ; Radiotherapy ; Sarcoma

PURPOSE: The Fas-associated death domain (FADD) constitutes a novel protein that specifically associates with the cytoplasmic death domain of Fas, and induces apoptosis. FADD is composed of a death effector domain (DED) and a death domain. In this study, we evaluated the in vivo antitumor effect of the FADD, or FADD-DED, gene in renal cell carcinoma cells, using a plasmid vector expressing the human FADD and FADD-DED genes. MATERIALS AND METHODS: The cDNA of the human FADD and FADD-DED genes were amplified by RT-PCR, and cloned to the pCR(R) 3.1. The expressions of the cloned FADD and FADD-DED (pCR(R)3.1-FADD and pCR3.1-FADD-DED) were observed by Western blot analysis. The efficacy of the growth inhibition by the cloned FADD and FADD-DED genes was tested, in vitro, on A498 and Caki-1 human renal cell carcinoma cell lines using the MTT assay. To evaluate the apoptosis, DNA fragmentation and caspase-3 assays were performed. RESULTS: Expressions of the FADD protein, and the FADD-DED, of the transfected A498 and Caki-1 cells had increased by 48 and 24 hours, respectively, compared with the control cell lines. The cytotoxicity of the pCR3.1-FADD and pCR3.1-FADD-DED on the A498 and Caki-1 cells significantly increased compared to the empty vector. The increased cytotoxicity of the FADD- or FADD-DED-transfected cell lines was associated with enhanced apoptosis, as assessed by DNA fragmentation and caspase-3 assays. CONCLUSIONS: Our results showed that the cloned FADD or FADD-DED expression plasmid vector efficiently inhibited the growth of A498 and Caki-1 human renal cell carcinoma cell lines. These data suggest that the exogenous FADD or FADD-DED expressions may have therapeutic applications in renal cell carcinomas.
Apoptosis* ; Blotting, Western ; Carcinoma, Renal Cell* ; Caspase 3 ; Cell Line ; Clone Cells ; Cytoplasm ; DNA Fragmentation ; DNA, Complementary ; Humans ; Plasmids

No abstract available.
Biofeedback, Psychology* ; Headache* ; Humans ; Muscle Tonus*

PURPOSE: The outcome of adjuvant systemic chemotherapy, in patients with a locally advanced transitional cell carcinoma of the upper urinary tract, was analyzed. MATERIALS AND METHODS: Between January 1990 and June 2001, a total of 97 patients underwent surgery for a transitional cell carcinoma of the upper urinary tract at our institute. Forty-five had a locally advanced disease (T3, N1, N2, lymphovascular invasion). Of these, 33 patients (chemotherapy group) underwent a median of four courses of cisplatin-based adjuvant systemic chemotherapy (M-VAC in 23, gemcitabine plus cisplatin in seven, CISCA in three), whereas 12 (Observation group) refused chemotherapy. To define possible prognostic factors in these patients, various factors, including age, sex, location, surgical method, pT stage and number of involved lymph nodes, were analyzed using the Cox's regression model. RESULTS: The mean follow-up was 39 months, ranging from 8 to 98 months; the median survival time in the chemotherapy and observation groups were 65 and 31 months, respectively. Five-year disease-specific survival rates in the chemotherapy and control groups were 71.1 and 40.9%, respectively. Of the several factors, adjuvant chemotherapy (p=0.016) and lymph node metastasis (p=0.017) both had prognostic significance. In the chemotherapy group, 21 (63.6%) were given a reduced dose for at least one cycle due to a reduced renal function. However, there was no fatal febrile neutropenia, while cellulitis or grade 3 neutropenia occurred in six patients during the chemotherapy. CONCLUSIONS: Our findings suggest that adjuvant systemic chemotherapy, for a locally advanced transitional cell carcinoma of the upper urinary tract, may lead to a significant prolongation in the survival time.
Carcinoma, Transitional Cell* ; Cellulitis ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy* ; Febrile Neutropenia ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes ; Neoplasm Metastasis ; Neutropenia ; Survival Rate ; Ureteral Neoplasms ; Urinary Tract*

PURPOSE: We reviewed our experiences, at a single-center, of patients with upper tract urothelial cancer in order to assess treatment outcomes and to determine the prognostic factors of the condition. MATERIALS AND METHODS: We retrospectively reviewed 115 patients, with urothelial tumors of the renal pelvis and ureter, treated at Seoul National University Hospital. The mean age of the patients was 61.1 years, with a mean follow-up of 35.5 months. Traditional prognostic factors, including age, sex, and tumor stage, grade, location, and type of surgical treatment, were analyzed with respect to disease recurrence and survival. RESULTS: Ninety six patients (83.4%) were treated surgically. A nephroureterectomy was performed in 88 patients (91.8%); 74 with bladder cuffing and 14 without. Actuarial 5-year survival rates, by tumor stage, were 100% for Ta, 90% for T1, 76.3% for T2 and 55.6% for T3. From the multivariate analysis, the T (p=0.008), N (p=0.017) and M (p=0.002) stages were significant prognostic factors for survival. A recurrence occurred in 46 (47.9%) patients at a mean of 13.1 months. Recurrent bladder tumors developed in 36.5 and 33.3% of patients treated with conventional nephroureterectomy, with bladder cuffing and other treatments, respectively. CONCLUSIONS: Tumor stage was a unique significant prognostic factor for survival on multivariate analysis and there is no significant difference in recurrence rate of bladder tumor regardless of surgical method. Bladder tumor surveillance should be carefully performed due to the high rates of recurrence in the bladder within 2 years postoperatively.
Follow-Up Studies ; Humans ; Kidney ; Kidney Pelvis ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract*

PURPOSE: We reviewed our experiences, at a single-center, of patients with upper tract urothelial cancer in order to assess treatment outcomes and to determine the prognostic factors of the condition. MATERIALS AND METHODS: We retrospectively reviewed 115 patients, with urothelial tumors of the renal pelvis and ureter, treated at Seoul National University Hospital. The mean age of the patients was 61.1 years, with a mean follow-up of 35.5 months. Traditional prognostic factors, including age, sex, and tumor stage, grade, location, and type of surgical treatment, were analyzed with respect to disease recurrence and survival. RESULTS: Ninety six patients (83.4%) were treated surgically. A nephroureterectomy was performed in 88 patients (91.8%); 74 with bladder cuffing and 14 without. Actuarial 5-year survival rates, by tumor stage, were 100% for Ta, 90% for T1, 76.3% for T2 and 55.6% for T3. From the multivariate analysis, the T (p=0.008), N (p=0.017) and M (p=0.002) stages were significant prognostic factors for survival. A recurrence occurred in 46 (47.9%) patients at a mean of 13.1 months. Recurrent bladder tumors developed in 36.5 and 33.3% of patients treated with conventional nephroureterectomy, with bladder cuffing and other treatments, respectively. CONCLUSIONS: Tumor stage was a unique significant prognostic factor for survival on multivariate analysis and there is no significant difference in recurrence rate of bladder tumor regardless of surgical method. Bladder tumor surveillance should be carefully performed due to the high rates of recurrence in the bladder within 2 years postoperatively.
Follow-Up Studies ; Humans ; Kidney ; Kidney Pelvis ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Ureter ; Ureteral Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract*

PURPOSE: We analyzed the impact of transurethral resection of the bladder (TUR-B) in patients with bladder cancer, in whom a subsequent cystectomy was performed. MATERIALS AND METHODS: We reviewed the records of 93 patients, with clinical stage T2 or less transitional cell carcinomas of the bladder that underwent a radical cystectomy at our institute. Before the radical cystectomy, TUR-B was performed for diagnostic and therapeutic purposes in all patients. We used the term "complete TUR" for the following procedures. No residual tumors were found after the TUR endoscopically, also, muscle layer should be present in the TUR specimens and no gross residual tumors were found in the cystectomy specimens by the pathologist. RESULTS: Eleven (26.8%) of the 41 patients with superficial bladder cancer had no evidence of residual tumors. Of the 19 patients with superficial bladder cancer that underwent complete TUR-B, 10 (52.6%) had no residual tumors. For the invasive tumors, 10 (19.2%) of the 52 patients that had a T2 stage disease had no residual tumors, and 10 (29.4%) of the 34 patients with a T2 stage disease, who underwent complete TUR-B, had no residual tumors. In the 38 patients with superficial bladder cancer, 17 (44.7%) changed to a higher stage. Of the 17 patients who underwent complete TUR-B, 3 (17.7%) changed to a higher stage. Among the patients with a T2 stage disease, those with the pT0 stage had a better survival than those with the pT2 stage with residual tumors (p=0.04). CONCLUSIONS: The completeness of TUR-B is important in evaluating residual tumors after a previous TUR-B in those patients with both superficial and invasive bladder cancers.
Carcinoma, Transitional Cell ; Cystectomy* ; Humans ; Neoplasm, Residual* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. METHODS: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. RESULTS: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity (1.5+/-0.7 [1~3] /day vs 4.5+/-2.9 [1~10] /day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was 2.5+/-0.5 (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count (8,403+/-1,737 [5,900~12,300] /mm3 vs 15,471+/-3,749 [5,400~20,800] /mm3)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. CONCLUSION: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over 13,500/mm3, abdominal ultrasonography is recommended to rule out APPE.
Abdomen ; Abdominal Pain ; Appendicitis* ; Child ; Diagnosis, Differential* ; Diarrhea ; Emergencies ; Fever ; Humans ; Leukocytes ; Lymph Nodes ; Mesenteric Lymphadenitis* ; Physical Examination ; Risk Factors ; Ultrasonography ; Vomiting

Femur ; Hematoma ; Muscle Weakness ; Pain, Postoperative ; Surgery, Oral ; Transplants