OBJECTIVE: In Gunsan, Jeollabuk-do, Korea, we wanted to determine if the sluggish local economy could affect citizens' health behaviors, especially mental health. METHODS: We divided Gunsan-si into 5 living areas and conducted Small-Area Estimations and confirmed the modified compound estimation value using the 2013-2017 Community Health Survey data and population data from Gunsan-si. RESULTS: The health behaviors and mental health of the residents of the western living area(Soryong-dong, Misung-dong), which is an industrial hub of Gunsan, had deteriorated or decreased compared to those of other regions. CONCLUSIONS Although there are limitations in analyzing the community health survey data using the small-area estimation method, it could be useful data for evaluating regional gaps and health level.

The simultaneous occurrence of primary glomerulonephritis in identical twins has been rarely reported previously. It has suggested that genetic factors may play an important role in the pathogenesis of primary glomerulonephritis. We describe a pair of 17-year-old identical twin brothers with asymptomatic proteinuria, one with histologically proven minimal change disease and the other with focal segmental glomerulosclerosis. HLA typing in twin brothers revealed an identical phenotype consisting of A25, A33, B44, B54, Cwl, Cw7, DR7 and DRB1. To our knowledge, this is the first case of glomerulonephritis in identical twins in Korea.
Adolescent ; Glomerulonephritis ; Glomerulosclerosis, Focal Segmental* ; Histocompatibility Testing ; Humans ; Korea ; Nephrosis, Lipoid* ; Phenotype ; Proteinuria ; Siblings* ; Twins, Monozygotic*

PURPOSE: 5-fluorouracil is one of the widely used chemotherapeutic agent whose metabolic product forms tight covalent binding complex with thymidylate synthase (TS) and thereby blocks the DNA synthesis process. Expression of TS has been studied as a mechanism of drug resistance and as a prognostic factor for various cancers. METHODS: The relation between TS expression in surgically resected specimens and clinicopathologic features was examined in 62 patients with gastric cancer. Immuno histochemical demonstration of the protein was achieved using an anti-TS monoclonal antibody. RESULTS: In Lauren's classification, TS expressions of the intestinal type and the diffuse type were 21.93% and 14.96% respectively (P=0.02). And TS expression in a group with lymphatic invasion was higher (26.15%) than that in a group without lymphatic invasion (16.15%)(P=0.0001). There were no significant differences between the TS expressions associated with other clinicopathologic features (P>0.05). CONCLUSION: For the purpose of assessing the applicability of TS expression as a prognostic factor and as a mechanism for drug resistance, assessment of TS expression must be standardized. Although direct correlations between TS expression and other clinicopathologic features were found only in Lauren's classification and lymphatic invasion, further investigations of the relation between TS expression and drug resistance of 5-FU must be continued to provide data for choosing chemotherapuetic agents for use in patients with gastric cancer.
Classification ; DNA ; Drug Resistance ; Fluorouracil ; Humans ; Stomach Neoplasms* ; Thymidylate Synthase*

STUDY DESIGN: Six patients with the lumbar kyphosis who underwent the circumferential fusion by posterior-anterior-posterior method were reviewed retrospectively from January 1998 to June 1999. OBJECTIVES: To determine whether patients with lumbar kyphosis can be successfully treated by circumferential fusion by posterior-anterior-posterior method. SUMMARY OF LITERATURE REVIEW: In the lumbar kyphosis, many procedures have been reported to correct the deformity, including multiple osteotomy, transpedicular vertebral resection, posterior interbody fusion, etc. Circumferential fusion by posterior-anterior-posterior method is suggested in this report as a valuable technique for excellent deformity correction and maintenance. MATERIAL AND METHODS: The surgery consists of posterior structural release with decompression followed by anterior structural release with interbody fusion by use of bone graft and posterior fixation. Clinical and radiologic results of the lumbar lordosis, sacral inclination and C7 plumb-line were assessed. RESULT: The mean segments of anterior and posterior fusion were 2.8 and 3.5 respectively. All clinical symptoms of patients had been improved in more than good. The average angle of lumbar lordosis was corrected from kyphosis 2.8degree preoperatively to lordosis 31.2degree postoperatively. At the last follow-up, the average loss of correction was 2.3degree . The average angle of sacral inclination was corrected from 6.7degree to 50.8degree . The distance from supero-posterior corner of S1 to C7 plumb line was reduced from 11.0 cm to 2.75 cm. CONCLUSION: The circumferential fusion by posterior-anterior-posterior method offer an effective surgical treatment, which produce excellent deformity correction, fusion rate, maintenance of the correction and good clinical outcome.
Animals ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis* ; Lordosis ; Osteotomy ; Retrospective Studies ; Transplants

The other generalized type of epidermolysis bullosa simplex (EBS) is a genetic blistering skin disease, caused by a mutation of the genes encoding keratin 5 and 14. EBS starts at birth and is characterized by generalized blisters following a minor trauma that heals with hyperpigmentation. A 19-year-old man presented with 19-year history of multiple erythematous vesicles in a herpetiform arrangement on the trunk, axilla, and thigh with post-inflammatory hyper-pigmentations. On light and electron microscopy, the biopsy specimen showed intraepidermal blisters that formed within the basal keratinocyte. The serum from a patient with bullous pemphigoid antibody and laminin 5 antibody showed the linear deposition at the floor of the blister on immunofluorescence mapping study. On the basis of our clinical, microscopic, and immunofluorescence findings, we diagnosed the patient as having a generalized type of EBS. Herein, we report on an interesting case of the other generalized type of EBS.
Axilla ; Biopsy ; Blister ; Cell Adhesion Molecules ; Epidermolysis Bullosa ; Epidermolysis Bullosa Simplex ; Floors and Floorcoverings ; Fluorescent Antibody Technique ; Humans ; Hyperpigmentation ; Keratin-5 ; Keratinocytes ; Laminin ; Light ; Methylmethacrylates ; Microscopy, Electron ; Parturition ; Pemphigoid, Bullous ; Polystyrenes ; Skin Diseases ; Thigh

PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.
Clinical Competence ; Humans ; Viperidae ; Surveys and Questionnaires

OBJECTIVE: To elucidate whether polymorphisms of matrix metalloproteinase (MMP)-1 and -2 promotor genes are associated with preterm delivery caused by preterm premature rupture of membranes (PPROM) in Korean pregnant women. METHODS: We conducted a case-control study of korean pregnant women admitted to our labor and delivery unit. PPROM group (n=31) was defined as women whom delivered before 37 weeks of gestation due to PPROM. Control group (n=291) included women who were delivered after 37 weeks of gestation and had no history of preterm delivery. Genomic DNA was extracted from maternal peripheral blood. Polymerase chain reaction (PCR) and direct sequencing were done to determine the genotype of MMP-1 promotor -1607 and MMP-2 promotor -1306 of each participant. Data was analyzed by 2-tailed unpaired t test, x2 test, odds ratio with 95% confidence interval (CI) using SPSS 10.0. RESULTS: The carrier rate of MMP-1*1G was significantly higher in the PPROM group than that in the control group (p=0.020; odds ratio 3.09, 95% CIl 1.14-8.35). The frequency of 1G allele of MMP-1 was also significantly higher in the PPROM group than that in the control group (p=0.011, odds ratio 1.97, 95% CI 1.16-3.36). There was, however, no significant difference in the carrier rate of genotype as well as in the allelic frequencies of MMP-2*T in PPROM group compared with the control group (p=0.430, odds ratio 1.48, 95% CIl 0.56-3.96; p=0.377, odds ratio 1.58, 95% CI 0.57-4.40). CONCLUSION: Our data suggest that polymorphism of MMP-1 promotor -1607 might be associated with PPROM in Korean pregnant women.
Alleles ; Case-Control Studies ; DNA ; Female ; Fenofibrate ; Genotype ; Humans ; Matrix Metalloproteinase 1* ; Membranes* ; Odds Ratio ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women* ; Rupture*

Human seminal fiuid (HSP) hypersensitivity is rare, but possibly a life-threatening disease. The pathogenesis of seminal plasma hypersensitivity and the exact nature of the HSP allergens remains to be clarified. We report a case of 25-year-old female patient who complained of severe itching sensation, flushing and edema of external genitalia, facial edema and dyspnea after sexual intercourse. The diagnosis was established by skin pr ick test with her husbands diluted semen. Intravaginal desensitization was performed by modified Matloffs method. Dilutions was made with sterile human serum albumin(0.2%) and 0.4% pheno1-0.9% saline solution. Two ml each of progressively greater concentrations of semen dilutions(1: 100,000 v/v, 1: 10,000 v/ v, 1:1,000 v/v, 1:100 v/v, 1:10 v/v) were inserted intravaginally at 45-min intervals, followed by an undiluted specimen. The patient was successfully desensitized and could have unprotected intercourse without anaphylaxis.
Adult ; Allergens ; Anaphylaxis ; Coitus ; Diagnosis ; Dyspnea ; Edema ; Female ; Flushing ; Genitalia ; Humans ; Hypersensitivity* ; Pruritus ; Semen ; Sensation ; Skin ; Sodium Chloride ; Spouses

PURPOSE: The aim of the present study aimed to evaluate the effect of testosterone on cardiovascular disease by using the Framingham Risk Score (FRS) in patients with sexual dysfunction. MATERIALS AND METHODS: A total of 308 men with sexual dysfunction were enrolled in this study. Clinical assessments included the 15-item International Index of Erectile Function (IIEF), blood pressure measurement, and clinical laboratory indexes. The FRS, which predicts the incidence rate of cardiovascular diseases in the next 10 years, was calculated on the basis of age, gender, total cholesterol, smoking status, high density lipoprotein cholesterol, and systolic blood pressure. RESULTS: The mean age of the 308 enrolled patients was 49.42+/-10.73 years, and the patients' mean body mass index (kg/m2) was 25.07+/-3.14. The mean total IIEF score was 28.44+/-18.06. The median total testosterone concentration was 3.2 ng/mL (interquartile range [IQR]: 2.3~3.2 ng/mL). The median calculated free and bioavailable testosterone concentrations were 0.052 ng/mL (IQR 0.039~0.070 ng/mL) and 1.30 ng/mL (IQR: 1.00~1.76 ng/mL), respectively. The mean FRS was 10.47+/-6.45. The FRS tended to show a negative correlation with the total and calculated free testosterone levels, but this was not significant (p=0.064 and p=0.074, respectively). In the multiple linear regression analysis, a significant negative correlation was observed between the total testosterone level and the FRS (p=0.048). CONCLUSIONS: The results suggest that the testosterone level is related to the FRS and that a high testosterone level may decrease the risk of cardiovascular disease.
Blood Pressure ; Body Mass Index ; Cardiovascular Diseases* ; Cholesterol ; Cholesterol, HDL ; Humans ; Incidence ; Linear Models ; Male ; Smoke ; Smoking ; Testosterone*

Heptaplatin is a recently developed platinum derivative. This agent has been reported to have a response rate of 17% as a single agent, and tolerable toxicity in the treatment of advanced gastric cancer. The aim of this study was to evaluate the efficacy and toxicity of a combination of 5-fluorouracil (5-FU) and heptaplatin in patients with advanced gastric cancer. Forty-seven chemotherapy-naive patients with advanced or recurred gastric cancer were recruited. 5-FU was administered over 120 hr by continuous intravenous infusion from day 1 to 5, at a daily dose of 1,000 mg/m2 and heptaplatin was administered over 1 hr by intravenous infusion on day 1 at 400 mg/m2, and this cycle was repeated every 4 weeks. The response rate was 21%, median progression-free survival was 1.9 months (95% CI, 1.6 to 2.2 months). Median overall survival was 6.2 months (95% CI, 4 to 8.4 months) and the 1-yr survival rate was 29% for all patients. The most frequent toxicity was proteinuria. Toxicities were generally mild and reversible. This study demonstrates that the combination of 5-FU/heptaplatin combination is less active but tolerated in patients with advance gastric cancer.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Disease-Free Survival ; Female ; Fluorouracil/*administration & dosage ; Follow-Up Studies ; Human ; Male ; Malonates/*administration & dosage ; Middle Aged ; Organoplatinum Compounds/*administration & dosage ; Stomach Neoplasms/*drug therapy ; Time Factors ; Treatment Outcome