BACKGROUND: Pain is among the most prevalent symptoms experienced by patients with cancer. Severe pain is incompatible with quality of life. Although cancer pain can be effectively treated in 70-90% of patients with the principle of pain management, between 60% and 70% of cancer patients pain is inadequately treated. Both knowledge and attitudes of medical professionals are important for effective pain management. This study was designed to survey residents knowledge and attitudes toward cancer pain management in order to offer the basic data for researching the problems and education program of cancer pain management. METHODS: In February 1997, we surveyed 116 residents practising in 7 departments of one university hospital, including physicians and surgeons, with a case-oriented questionnaire assessing knowledge and attitudes toward cancer pain management. RESULTS: The percentage of residents choosing the correct answer for knowledge about pain management was, pain in the drug abuser(42.2%), equianalgesic dosing(47.4%), physical dependence(50.9%), WHO analgesic ladder(61.2%), neuropathic pain(62.9%), around the clock dosing(69.8%). The percentage of residents choosing answer for attitude toward cancer pain management ; upper limit to opioid prescription(46.5%), reluctance to prescribe morphine(45.7%), need of education for pain management(99.1%). Fear of side effects was the most frequent reason of their reluctance to prescribe opioids(80.4%.) Physicians had higher level of knowledge than surgeons(P=0.004). CONCLUSIONS: This study shows the presence of barriers to adequate pain control in Korea as identified in other countries. There is the lack of konwledge about cancer pain management and doctors are reluctant to prescribe because of negative attitudes towards pain management. This suggests a need for not simply offering knowledge but problemsolving education and training of pain management.
Education ; Humans ; Korea ; Pain Management* ; Quality of Life ; Surveys and Questionnaires

No Abstract Available.
Depression* ; Primary Health Care*

No Abstract Available.
Depression* ; Primary Health Care*

One may sometimes complicated with non-union of the tibia with intact fibula or comparatively early united fibular fracture during the cause of treatment of crural fractures. So that the fibula is to strut the tibial fragment preventing effective contact. Several authors have sporadically reported the removal of a portion of fibula may increase potential compression force across the tibial fracture site and promote bony union of non-delayed union of the tibia. Partial fibulectomy was performed in 9 patients with established nonunion of the tibia at National Medical Center from 1975 to 1982. The results were as follows: 1. Healing occurred in 8 of the 9 cases, and average time to union was 7.4months after fibulectomy. 2. In one case performed B-K amputation due to intractable infection after partial fibulectomy. 3. The average shortening of the involved lower limb was about 1.9cm. 4. All cases did not have significant symptoms at the fibulectomy site after union. 5. Partial fibulectomy proved to be a relatively effective method for the treatment of nonunion of the tibia.
Amputation ; Fibula ; Humans ; Lower Extremity ; Methods ; Tibia ; Tibial Fractures

PURPOSE: Recently there have been some reports that percutaneous absces drainage(PAD) was ineffective in treating multiloculated liver abscess. We therefae, reviewed our results of catheter drainage in jultiloculated liver absces. MATERIALS AND METHODS: PADs in 10 cases of multiloculated liver abscesses were performed with 8.5F Pig tail, 12 & 14F Sump cahteters, under ultrasonic & fluoroscopic guidance. RESULTS: All the 10 cases were successfully drained without major complications. Mean drainage duration was 16.3 day and the result was not significantly different from those obtained by draining unilocular pyogenic liver abscess. The success was the result of using large caliber catheter and repetition in insertion of guidewire deeply into abscess cavity to make communications between the Iocules which was proven by abscessogram. CONCLUSION: PAD was safe and effective method for multiloculated abscess as unilocular liver abscess, and it is recommended that the multiloculated liver abscess be draincd.
Abscess* ; Catheters ; Drainage* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Ultrasonics

Microcopic polyangiitis (MPA) is a systemic disorder affecting small vessels. In MPA, the central nervous system involvements have rarely been reported. We experienced a case of MPA with subdural effusion and pachymeningitis in a 50-year-old woman. The diagnosis of MPA was made by the presence of mononeuritis multiplex, hematuria, pachymeningitis, and p-ANCA seropositivity in this patient. Subdural effusion was of exudates and an active suppurative inflammation was observed on the dural biopsy.
Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Central Nervous System ; Diagnosis ; Exudates and Transudates ; Female ; Hematuria ; Humans ; Inflammation* ; Meningitis ; Microscopic Polyangiitis* ; Middle Aged ; Mononeuropathies ; Subdural Effusion*

We examined trends in obesity among Korean adults, using body mass index (BMI) and waist circumference (WC) as reported in national surveys. Data (10,043 men and 12,758 non-pregnant women) were derived from four waves of the Korea National Health and Nutrition Examination Survey conducted in 1998, 2001, 2005, and 2007. Between 1998 and 2007, the distribution of BMI and WC showed shifts toward the right among men. Mean values of BMI and WC and the corresponding overweight (includes obesity) and obesity prevalences showed increasing trends in men but not in women. Women aged 60+ showed significant increases in obesity measures, including mean BMI and WC, and the associated prevalences. Among women aged 20-39, the prevalence of underweight increased significantly between 1998 and 2007, and BMI showed a decreasing tendency. These time trends in young women were the reverse of the trends in young men. In conclusion, policy efforts to abate overweight and obesity trends need to be exercised among men and older women. In addition, more national studies regarding potential increases in underweight among young women are warranted.
Adult ; Body Mass Index ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Nutrition Assessment ; Obesity, Abdominal/*epidemiology ; Overweight ; Regression Analysis ; Republic of Korea ; Thinness/epidemiology ; Waist Circumference

BACKGROUND: The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart anomalies. So, at the moment, it is believed that avoidance of suspected environmental factors in early pregenancy is most certain preventive measure of congenital heart anomalies. This study has been undertaken in order to find the possible environmental risk factors for congenital heart anomalies in Korea. METHOD: A total of 320 mothers of infants with congenital heart anomalies diagnosed at Seoul National University Hospital were included in this study as case group. And 413 mothers of healthy infants, who visited well baby clinic at the hospital during the same period of 2 years from 1987, comprised the control group. Data related to environmental risk factors including drug use during the first trimester of pregnancy, any other confounders were collected by direct interview using questionmaires. RESULT: There were positive associations for lower educational level of mother, indoor smoking habit of father, number of pregnancy, and of experience of previous abortion of mother, and multiple(or twin) birth. Relative risk estimates for the first trimester exposure to anti-emetics and herb medicine were 2.1(p<0.006) and 1.4(p<0.044), respectively. Data showed a positive association between anti-inflammatory drug exposure and congenital anomalies of pulmonary valve(OR=22.7, p<0.01), and between anti-histamine exposure and coarctation of aorata(OR=12.7, p<0.017). CONCLUSION: Environmental factors such as smoking habit of father, certain drugs used in early pregnancy, plays a role in the etiology of congenital heart anomlaies. Further studies, designed to focus on specific drug and to differentiate the effect of the suspected drug and to differentiate the effect of the suspected drug form that of the underlying conditions prompting its use, should be called upon.
Abortion, Induced ; Antiemetics ; Case-Control Studies* ; Fathers ; Female ; Heart* ; Humans ; Infant ; Korea* ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Seoul ; Smoke ; Smoking

In an attempt to define quantitatively the relation between left atrial size and atrial fibrillation, echocardiography was used to study 58 patients with mitral stenosis and sinus rhythm, 22 patients with mitral stenosis and newly appeared atrial fibrillation, 62 patients with mitral stenosis and atrial fibrillation, 14 patients with sinus rhythm who undergone mitral valve replacement, 18 patients with atrial fibrillation who undergone mitral valve replacement,17 patients with idiopathic atrial fibrillation and 22 control persons. In all groups of mitral stenosis, atrial fibrillation was rare when left atrial dimension was below 40mm but common when this dimension exceeded 40 mm. When left atrial dimension exceeded 50 mm, sinus rhythm was rare even in patients who undergone mitral replacement operation. These data suggest that left atrial size is an important factor in the development of atrial fibrillation. To reduce the risk of systemic embolism complicating atrial fibrillation and to reduce the need of long term anticoagulant therapy postoperatively, the left atrial dimension should be followed closely for the patients with mitral stenosis.
Atrial Fibrillation* ; Echocardiography* ; Embolism ; Heart Atria* ; Humans ; Mitral Valve ; Mitral Valve Stenosis

BACKGROUND: Pneumoconiosis is a parenchymal lung disease that results from the accumulation of coal dust in the lungs and the consequent tissue reaction. To evaluate the role of various personal factors in pneumoconosis and the significance of some serologic markers for assessing the disease activity related to pneumoconiosis, the Rheumatoid Factor(RF), α1-AT, C-Reactive Protein(CRT), ceruloplasmin and fibrinogen levels were measured. METHOD: All the patients were males, 45-76 years old, and the mean duration of coal dust exposure was 23.2 years. 51 patients were classified as having Simple Pneumoconiosis (SP), 59 had Progressive Massive Fibrosis (PMF). Fifty eight men with ages ranging from 26-70 years wer used as normal controls. The serum RF and CRT were titrated using an Autochemistry analyzer (HITACHI 7150 : Japan) and the α1-AT and ceruloplasmin levels were measured using a Nephelometer (Behring Nephelometer : Germany) and the fibrinogen levels were estimated by using and Autoanalyzer for hematologic coagulation. RESULT: There was a higher RF level in the SP, and PMF groups than in the control groups but there was no statistical difference. The CRP, α1-AT, and ceruloplasmin levels were also higher in the SP, and PMF groups. However, the fibrinogen concentration was within the normal ranges in both the SP and PMF groups. CONCLUSION: The CWP (Ed note : Define CWP) patients had significantly higher CRP, α1-AT, and ceruloplasmin levels compared to the control group. It is believed that these serologic changes could be used as a marker of the disease activity.
C-Reactive Protein ; Ceruloplasmin ; Coal* ; Dust ; Fibrinogen ; Fibrosis ; Humans ; Lung ; Lung Diseases ; Male ; Pneumoconiosis* ; Reference Values ; Rheumatoid Factor