BACKGROUND: Up to the present, there has been little study on chronic fatigue or chronic fatigue syndrome, and there is equally sparse relevant statistical data For this reason, we attempted to investigate the present status of fatigue, particularly its incidence and actual conditions. METHODS: The study subjects were 12,152 outpatients who visited family practice in hospitals all over Korea between July 24 and September 21, 1997. They were given a questionnaire which included questions reflecting the (U.S.) Center for Disease Control criteria defining chronic fatigue syndrome. RESULTS: Among the subjects, 861 people complained of fatigue in their response to the questionnaire and they became the focus of the study. Of this fatigue group, 426 people(49.4%) had rnanifested fatigue for more than 6 manths, and the male/female ratio was 54%/46%, respectively. People who re ported that fatigue impaired their ability to function on a daily basis made up 35.8% of the fatigue group and the percentage of people who had considered visiting a clinic duen to fatigue wasa unexpectedly high 52.8%. The reported causes of fatigue, in decreasing order, were. social interactio(mals 68.5%/ femals 45.1%); sleep disturbance(mals 26.8%/ femals 21.8%); and physical maladies(mals 24.2%/femals 26.5%). There were significant gender differences in social interaction relating to domestic problems(mals 4.7%/femals 16.7%) and emotional problems(mals 12.2%/femals 21.4%). Among 33 chronic fatigue syndrome patients who indicated what they thought were the causes of their problems, 68.8% reported physical maladies, 65.6% social life, 31.3% emotional problems, 21.9% sleep disturbance, and 21.9 % domestic problems. The associated symptoms of fatigue reported in both males and females, in decreasing order, included: myalgia, headache and neurologic symptoms. The prevalence of chronic fatigue was 0.27%. CONCLUSIONS: Our study showed that 7.1% of family practice outpatients complained of fatigue and that their daily activities or occupational life were disturbed as a result. This group demanstrates is serious need for medical assistance. Therefore, doctors should have more interest in fatigue, particularly in chronic fatigue syndrome, so as to provide real and versatile care.
Centers for Disease Control and Prevention (U.S.) ; Family Practice ; Fatigue Syndrome, Chronic ; Fatigue* ; Female ; Headache ; Humans ; Incidence ; Interpersonal Relations ; Korea ; Male ; Medical Assistance ; Myalgia ; Neurologic Manifestations ; Outpatients* ; Prevalence ; Surveys and Questionnaires

PURPOSE: Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme regulating folate level, which affects DNA synthesis and methylation. MTHFR is highly polymorphic, and its variant genotypes result in decreased MTHFR enzyme activity and lower plasma folate level. Generally, a low folate level is known to be associated with a gastrointestinal neoplasm. Three common single nucleotide polymorphisms (SNPs) resulting in amino-acid changes (C677T, A1298C and G1793A) have been reported in MTHFR. We studied the relationship of MTHFR C677T, A1298C and G1793A polymorphisms between from colon cancer group and control group of Korean people. METHODS: We performed a case- control study to examine the relationship between MTHFR C677, A1298C, and G1793A polymorphisms and the risk of colon cancer. Two hundred seven (207) individuals with colon cancer and 288 healthy persons were analyzed. Blood sampling of each group was performed, and (PCR-RFLP) was analyzed; as a result, MTHFR polymorphism genotypes were obtained. RESULTS: The genotype frequencies of MTHFR C677T polymorphisms were 27.1% (CC), 48.3% (CT), 24.6% (TT), and 72.9% (CT+TT) in the patient group and 39.2% (CC), 36.8% (CT), 24.0% (TT), and 60.8% (CT+TT) in the control group. The genotype frequencies of MTHFR A1298C polymorphisms were 58% (AA), 35.7% (AC), 6.3% (CC), and 42% (AC+CC) in the patient group and 55.6% (AA), 40.3% (AC), 4.2% (CC), and 44.4% (AC+CC) in control group. The genotype frequencies of MTHFR G1793A polymorphisms were 83% (GG), 15.9% (GA), 1% (AA), and 16.9% (GA+AA) in the patient group and 85.8% (GG), 11.8% (GA), 2.4% (AA), and 14.2% (GA+AA) in the control group. The 677CT genotype was associated with a significantly increased risk for colon cancer (adjusted OR=1.90, 95% confidence interval: 1.25~2.90 in CT) than the 677CC genotype. The 1298CC, 1298AC, 1793AA, and 1793GA genotypes were not associated with a significantly increased risk for colon cancer. CONCLUSIONS: The MTHFR C677T polymorphism may influence colon cancer, but the MTHFR A1298C and G1793A polymorphisms need to be studied further for careful interpretation and confirmation in larger studies.
Colon ; Colonic Neoplasms ; DNA ; Folic Acid ; Gastrointestinal Neoplasms ; Genotype ; Humans ; Methylation ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma ; Polymorphism, Single Nucleotide

This study sought to demonstrate bone mineral density (BMD) conditions in elderly female patients with knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA). In addition, we sought to determine whether their BMD conditions differ from those of community-based females without knee OA. Finally we sought to determine whether clinical statuses are related to BMD in the knee OA patients. BMD conditions in 347 female patients undergoing TKA and 273 community-based females were evaluated. Additionally, comparative analyses of BMD between age and body mass index-matched knee OA groups (n=212) and the control groups (n=212) were performed. In the pre-matched knee OA group, regression analyses were performed to determine whether preoperative clinical statuses were related to BMD. Considerable prevalence of coexistent osteoporosis (31%) was found in the pre-matched knee OA patients undergoing TKA. We found no significant differences of the BMD T-scores and the prevalence of osteoporosis between the age and body mass index-matched knee OA and control groups. In the pre-matched knee OA patients, poorer preoperative clinical scores were related to poorer BMD T-scores in the proximal femur and/or lumbar spine. Our study suggests that more attention should be paid to identify and treat osteoporosis in elderly female patients with advanced knee OA undergoing TKA.
Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Knee ; Body Mass Index ; Bone Density ; Female ; Humans ; Knee Joint/pathology/surgery ; Osteoarthritis, Knee/*epidemiology/*surgery ; Osteoporosis/*epidemiology

Gastric anisakiasis is a parasitic disease caused by the gastric mucosal penetration of the Anisakis larvae ingested with raw fish. Acute gastric anisakiasis is diagnosed by the endoscopic visualization of Anisakis larvae along with mucosal edema, erythema, hemorrhage, and/or an ulcer, whereas chronic anisakiasis is often observed as a localized tumor commonly occurring in the submucosal layer, and is characterized by eosinophilic granuloma with edema and embedded Anisakis larvae on pathological examination of surgical specimens. We report here a case of chronic gastric anisakiasis provoking a bleeding gastric ulcer, which is a rare clinical manifestation of this condition.
Anisakiasis* ; Anisakis ; Edema ; Eosinophilic Granuloma ; Erythema ; Hemorrhage* ; Larva ; Parasitic Diseases ; Stomach ; Stomach Ulcer* ; Ulcer

The use of alternative medicine for smoking cessation have been increasing steadily in recent years. A series of clinical group studies was performed to clarify the effect, outcome and success rate of an acupuncture treatment for smoking cessation. This study was conducted for four weeks using 238 smoking students at 2 high schools. The subjects were separated into two groups: 159 students were treated with acupuncture on the anti-smoking acupoints of the ear, which is known to be effective for cessation of smoking (case group), and 79 students were treated at other sites of the ear (control group). The acupuncture treatment was alternately administered at each side of the ears on a weekly basis for 4 weeks. The smoking cessation success was only 1 case (0.6%) in the case group and none in the control group after 4 weeks. The change in the taste of tobacco and the intensity of the desire to smoke were not significantly different between the case and control groups, but the case group showed a tendency of reduction in the taste of tobacco and the intensity of the desire to smoke. In addition, the reduction in cigarette consumption was not significant, but the tendency of reduction in the study group was significant. It is believed that the site of auricular acupuncture for smoking cessation is not important. However, there was a significant tendency in terms of the reduction in cigarette consumption, the taste of tobacco and the intensity of the desire to smoke in the case group, indicating that auricular acupuncture in smoking cessation has some effect.
*Acupuncture, Ear ; Adolescent ; Humans ; Male ; Smoking Cessation/*methods ; *Students ; Treatment Outcome

PURPOSE: Despite increased effort for the detection of early colorectal cancer, advanced disease presenting as obstruction or perforation still accounts for 8 to 29% and 3-8% of all colorectal cancers, respectively. The aim of this retrospective study was to evaluate the clinical characteristics, the surgical methods, the complications, and the risk factors of obstructive or perforated colorectal cancer that may influence the outcome. METHODS: A retrospective study was carried out in 60 patients with colorectal cancer, who underwent surgery due to obstruction or perforation from March 2000 to December 2005. The colorectal cancers were considered to be complicated when clinical signs of peritonitis were observed, the radiologic characteristics of the tumor did not permit preoperative mechanical bowel preparation, or perforation existed, when these observations were confirmed by operative findings. The following data were analyzed: clinical characteristics, surgical methods, complications, and risk factors. RESULTS: Thirty-three patients (55%) had obstruction, and 27 patients (45%) had perforation. Overall, major complications occurred in 33.3% and 48.5%, respectively. The mortality rates were 6.1% and 14.8%, respectively. Risk factors for major complication were age, perforation, and transfusion whereas those for mortality were perforation and American Society of Anesthesiologists (ASA) class. CONCLUSION: The risk factors of complication were old age, transfusion, and perforation and those for mortality was perforation and ASA class. Earlier diagnosis and prompt, intensive, careful management should be attempted in these high-risk patients.
Colorectal Neoplasms ; Emergencies ; Humans ; Multivariate Analysis ; Peritonitis ; Retrospective Studies ; Risk Factors

No abstract available.
Death Certificates* ; Korea*

BACKGROUND/AIMS: Most cases of hepatitis B virus (HBV) are transmitted vertically in endemic areas of HBV. The positivity of serum HBeAg/HBV DNA in pregnant women is associated with vaccine failure. Recently, a national program for HBV vaccines free of charge in neonates born to HBsAg-positive pregnant women is being performed. The aim of this study was to investigate the positivity of serological markers of HBV in pregnant women in Jeju, which is an island separated from the Korean peninsula and a promising cohort to evaluate the effect of a prevention program of HBV infection. In addition, we investigated the geographic differences in the prevalence of HBV infection because it has been reported that the prevalence of HBV has been high in this area previously. METHODS: Between January 2001 and December 2002, all women who gave delivery were studied retrospectively. Women between the ages of thirty and forty, who received health screening at the Asan Medical Center health promotion center in Seoul, were analyzed as controls. RESULTS: During the study period, 1,030 pregnant women (30.8 +/- 4.3 years) and 7,270 controls (33.1 +/- 5.0 years) were enrolled. The positivity of HBsAg was high in Jeju compared with that of Seoul (6.4% vs. 4.9%) (P=0.036). The positivity of HBeAg/HBV DNA was 31.8% (21/66) in HBsAg-positive pregnant women. The positivity of anti-HBs was low in Jeju compared with that of Seoul (54.5% vs. 68.8%) (P<0.001). CONCLUSIONS: The positivity of HBsAg was found to be high in pregnant women in Jeju. Intensive supervision for HBV infection in pregnant women should be given in this area.
Adult ; DNA, Viral/blood ; English Abstract ; Female ; Hepatitis B/diagnosis/*epidemiology ; Hepatitis B Surface Antigens/blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics/isolation & purification ; Humans ; Korea/epidemiology ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis/*epidemiology ; Seroepidemiologic Studies ; Serologic Tests

BACKGROUND: Smoking is the single most considerable factor, which may likely affect one's health most adversely. Therefore, an effective control upon smoking has been the most important issue for all of the practitioners. Furthermore, the latters concern an the alternative medicine has been steadily mounting these days. Accordingly, a series of clinical group study has been mapped aut in order to clarify the effect and the outcome of acupuncture treatment and its rate of success. METHODS: The survey has been conducted fram April 7th, 1998 for six months with the voluntary help of 130 students as our study objects, who were the 1st, 2nd and 3rd graders at two metropolitan high-schools in Seoul A basic questionnaire has been prepared and collected at the first interview. The acupuncture treatment has been alternately administered at each side of ears once a week for the respective object-students and the information had been questioned in the survey. When 5 months lapsed with no treatment after the initial four weeks of intensive application, a further follow-up survey was repeated all over again(once every week for 4weeks and another after 6 months). For the analysis of our finding, the SAS V6.12 has been used together with the one way ANOVA test, t-test, and Cochran-Armitage trend test. RESULTS: Those who managed to stop smoking after the acupuncture treatment of one week, four weeks and six months respectively were found as follows; 2 students(61%), 12 students(37.5%), and 8 students(25%), proving that the success rate for smoking cessation after six months was 25%. Those who decreased their number of smoking more than half were; 13 students(39.4%), 15 students(46.9%), 25 students(75%). The number of withdrawal symptom and the smoking cessation as well as the smoking reduction rate were not found co-related each other. The frequency of their smoking, the frequency of the smoking attempt, the period of their abstinence from smoking, the facts whether their family-members of relatives smoked or not, the FTQ(Fagerstrom Tolerance Questionnaire), the frequency of their drinking and the motivation types of smoking(Why test) were found not influential upon the change of smoking tastes and their intensity of smoking wish by the treatment of the auricular acupuncture. CONCLUSIONS: The change of smoking taste and the change on the intensity of smoking wish as the outcome of acupuncture treatment for the stop-smoking has been statistically siganificant.
Acupuncture* ; Acupuncture, Ear ; Complementary Therapies ; Drinking ; Ear ; Follow-Up Studies ; Humans ; Motivation ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking* ; Substance Withdrawal Syndrome ; Surveys and Questionnaires

Anisakiasis usually occurs in the stomach and can easily be diagnosed by digestive tract endoscopy as opposed to enteric anisakiasis which is very rare and difficult to be diagnosed definitively. The most important and useful tool in diagnosing enteric anisakiasis is obtaining an accurate patient history of having eaten raw fish before the onset of symptoms. We report a case of small bowel obstruction caused by acute invasive enteric anisakiasis. A 60-year-old woman visited the emergency room suffering from sudden abdominal pain. She had eaten raw fish 1 day before the onset of symptom. Radiologic studies showed small bowel obstruction. However, no definitive cause could be found. An emergency laparotomy revealed edematous and dilated proximal jejunum and a focal stenosis of the distal jejunum. Segmental resection of the jejunum was performed, and histopathological examination revealed enteric anisakiasis. The patient was discharged on the 7th day after surgery following an uneventful course of recovery.
Acute Disease ; Animals ; Anisakiasis/complications/*diagnosis/surgery ; Anisakis/isolation & purification ; Diagnosis, Differential ; Female ; Humans ; Intestinal Obstruction/*diagnosis/etiology/radiography ; Intestine, Small/pathology ; Middle Aged ; Tomography, X-Ray Computed