OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

In the past 5 years, the authors have performed microsurgical reconstruction of the lower leg in 37 patients. Among them, modified microsurgical salvage procedures were performed in 11(29.7) cases with vascular compromise, suggested by the preoperative angiogram of the affected lower leg demonstrating no visible, or only one visible major arter. Modified salvage procedures included free flap operations using distally-based arterial inflow(n=2), temporary diversion of the single main artery with secondary vein grafting(n=2), Jungcross-leg fashioned free flaps(n=4), and end-to-side anastomosis of the main artery((n=1). In absence of arterial flow after lower leg trauma, as interpositional vein graft(n=2) was performed to restore blood flow. No vascular problems occurred after the free flap transfer. However, 9 patients experienced different degrees of limping gait, ranging from as mild(n=2), moderate(n=6) to severe(n=1) at the mean follow-up period of 18 months. In reconstruction of a vascular compromised lower leg, modified salvage procedures should be reviewed and selected after exploration of all vessels, both proximal and distal to the zone of the injury. When evaluating what method is the most appropriate, socioeconomic efficiency and patients' individual requirments should be considered.
Arteries ; Follow-Up Studies ; Free Tissue Flaps ; Gait ; Humans ; Leg* ; Veins

Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.
Arthrodermataceae ; Candida ; Fungi ; Health Personnel ; Humans ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

Nevus sebaceus of Jadassohn is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. This case was characterixed by multiple basal cell epitheliomas, clinically one reddish nodule and multiple pigmented papules, arising in the nevus sebaceus. Histologically, epithelial papillomatous hyperplasia and high-positioned hyperplastic sebaceous glands were found, and tumor nests consisting of basaloid cells with peripheral palisading arrangements were mainly situated in the upper dermis without significant infiltrative growth. We report a rare case of nevus sebaceus with multiple basal cell epitheliomas in the right cheek of a 49-year-old woman.
Carcinoma, Basal Cell* ; Cheek ; Dermis ; Female ; Hamartoma ; Humans ; Hyperplasia ; Middle Aged ; Nevus* ; Nevus, Sebaceous of Jadassohn* ; Sebaceous Glands ; Skin

No abstract available.
Immunoglobulin G* ; Inflammation*

Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist.
Biopsy ; Biopsy, Needle* ; Humans ; Korea ; Needles* ; Neurilemmoma*

PURPOSE: Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. MATERIALS AND METHODS: This is a retrospective study of 181 cervical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. RESULTS: The positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (<1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1~13 months). Negative linear corelation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. CONCLUSIONS: SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Female ; Humans ; Multivariate Analysis ; Prognosis ; Radiotherapy ; Recurrence* ; Reference Values ; Retrospective Studies ; Uterine Cervical Neoplasms

OBJECTIVE: To test if the intake of H2 receptor antagonists (H2-RAs) increases the risk of gastric cancer in the elderly. METHODS: The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1993. The information on H2-RAs exposure was obtained from a drug prescription database compiled between Jan. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. RESULTS: After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 (95% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). CONCLUSION: The intake of H2-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.
Achlorhydria ; Aged* ; Body Mass Index ; Busan ; Case-Control Studies* ; Cimetidine ; Cohort Studies ; Drug Prescriptions ; Famotidine ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Logistic Models ; Odds Ratio ; Parturition ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Ranitidine ; Stomach Neoplasms* ; Stomach Ulcer

PURPOSE: Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications. MATERIALS AND METHODS: This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months (mean 60 months) and age of patients ranged from 31 to 78 years at presentation (mean : 55 years). RESULTS: Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight (16.8%) patients developed late rectal and urinary complications. There were tendency to increasing severity and frequency according to increased fractional dose and total (rectal and bladder) dose. CONCLUSIONS: Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder doseaffected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications.
Adenocarcinoma ; Cervix Uteri* ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

PURPOSE: Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. METHODS AND MATERIALS: Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. RESULTS: Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. CONCLUSION: Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease remained after inappropriate hysterectomy was poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision ; Myoma ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms ; Uterine Hemorrhage ; Uterine Prolapse