This study was designed to identify the factors relating to the retrieval of medical information from the Internet by patients at a general hospital in Seoul. A questionnaire survey was carried out for 440 inpatients and outpatients who visited the general hospital by 20 educated nurses between 24 and 25 October, 2002. The collected data were analyzed to evaluate the relationship between socioeconomic characteristics and Internet use, and opinions about medical information on the Internet and Internet use, by t-tests or chi-square tests. A logistic regression analysis was applied to find models explaining the factors affecting Internet use and the search for medical on the Internet. According to our logistic regression analysis, the younger, better educated, higher income, and singles showed a higher Odds ratio for Internet use. Age, education period, income and confidence level of the Internet contents were statistically significant in the search for medical information on the Internet(p< 0.05). The results showed the customers characteristics, needs, and problems with using the Internet in medical area on the customer s views. These results would be useful for building marketing strategies using the Internet as a way of servicing and communicating with the patients.
Education ; Hospitals, General* ; Humans ; Information Storage and Retrieval* ; Inpatients ; Internet ; Logistic Models ; Marketing ; Odds Ratio ; Outpatients ; Surveys and Questionnaires ; Seoul*

OBJECTIVE: To investigate whether polymorphisms of gene encoding CYP1B1 is associated with the risk of endometriosis in Korean women. METHODS: We investigated 199 patients with histopathologically confirmed endometriosis rAFS stage III/IV and 183 control group women who were surgically proven to have no endometriosis. The genetic distribution of four different CYP1B1 polymorphisms at G119-T, G432-C, T449-C, and A453-G were analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism of PCR products. RESULTS: We found no overall association between each individual CYP1B1 genotype and the risk of endometriosis. The odds ratio of genotype GG/GC+GG/TC+TT/AA compared to GG/CC/CC/AA (reference) was calculated as 2.06 with a 95% confidence interval of 1.003~4.216. CONCLUSIONS: This results suggest that CYP1B1 genetic polymorphism may be associated with development of endometriosis in Korean women.
Endometriosis* ; Female ; Genotype ; Humans ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

OBJECTIVES: Amenorrhea, one of the most common side effects of neuroleptics, has known to be associated with prolactin elevation. Hyperprolactinemia seriously affects mental health causing depression, anxiety or hostility, while also affecting physical health causing amenorrhea, galactorrhea or sexual dysfunction. The possible correlation between risperidone-induced amenorrhea and depression, anxiety and quality of life was evaluated in a cross-sectional open study. METHODS: During a five-month period, WHO quality of life-BREF (WHOQOL), Beck depression inventory (BDI) and Statetrait anxiety inventory (STAI) were applied twice at two-month intervals for 30 patients with risperidone-induced amenorrhea and 22 patients without amenorrhea. RESULTS: Amenorrhea group had significantly higher scores in BDI and STAI-state, while showing lower scores in the quality of life than control group. The total BDI and STAI-state scores were more negatively correlated with WHOQOL score in amenorrhea group. CONCLUSION: Patients with risperidone-induced amenorrhea rated themselves significantly more depressed and more anxious, and a lower quality of life compared to the control group. Clinicians should be more active in evaluating and treating hyperprolactinemic side effects such as amenorrhea, galactorrhea, depression and anxiety.
Amenorrhea* ; Antipsychotic Agents ; Anxiety* ; Depression* ; Female ; Galactorrhea ; Hostility ; Humans ; Hyperprolactinemia ; Mental Health ; Pregnancy ; Prolactin ; Quality of Life* ; Risperidone* ; Schizophrenia

OBJECTIVES: We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. METHODS: A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1- May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. RESULTS: Among 985 survey respondents (380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. CONCLUSIONS: In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.
Adult ; Age Factors ; Aged ; Female ; *Health Behavior ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Social Support ; Socioeconomic Factors ; Stomach Neoplasms/*diagnosis

PURPOSE: The purpose of this study is to assess the priorities of health promotion for older adults in the rural community. The study attempts to display demographic characteristics subjective health status and chronic diseases status of the older adults. METHODS: We surveyed 384 senior residents in a community via face-to-face interviews in their homes, who were selected by proportional random sampling. We analysed the frequency, multiple responses and chi2 by SPSS 12.0K. RESULTS: The mean of subjective health status was 54.04+/-21.69 with a maximum of 100. Our study found that the high priorities in health promotion for older adults were prevention and management of hypertension and diabetes, strengthening of joint and muscles, cancer screening and physical exercise. Prevention of depression and social activities were low priorities. Strengthening of joints and muscles was a high priority among women while smoking cessation and social activities were high priorities of men. CONCLUSION: In conclusion, health promotion priorities of older adults differed by gender and subjective health status. Disease-related priorities received more attention than psycho-social health priorities. This study suggests comparing the priorities regionally and nationally.
Adult* ; Chronic Disease ; Depression ; Early Detection of Cancer ; Exercise ; Female ; Health Priorities ; Health Promotion ; Humans ; Hypertension ; Joints ; Male ; Muscles ; Rural Population* ; Smoking Cessation

OBJECTIVE: In trauma patients, the distribution of time to death can be used in many ways. We examined the distribution of time to death in trauma patients who expired during a 10-year and analyzed the risk factors of early deaths. METHOD: From January 1994 to December 2003, trauma patients who had been admitted and had expired at tertiary hospitals were enrolled. A retrospective study was done to determine the distribution of trauma mortality and compared the differences between patients who succumbed during the first 5 years and those who succumbed during the second 5 years. We also analyzed the risk factors associated with early deaths that occurred within 6 hours after injury. RESULT: The distribution was bimodal for both the first and the second 5 years. During the second 5 years, there was about two times as many death within 1 hour after injury. The average ages were 36.5 years for the first 5 years and 43.6 years for the second 5 years (p<0.05). The transport times were 35 minutes for the first 5 years and 31.5 minutes for the second 5 years, and the transports by EMS (119) increased from 45.2% to 77.1%. Motor vehicle accidents were the most common mechanism of injury in both periods, but the number was lower in the second 5 years (p<0.05). The most common causes of death were injuries of head and spine and hemorrhages. Risk factor of early deaths were injury of nervous system and chest trauma. CONCLUSION: In our study, the distribution of trauma mortality was bimodal pattern. The trauma system in Korea should be improved to decrease the early and the late peak. To decrease early deaths, it is important to prevent accident, develop EMS for early transport and pre-hospital management, and connect effectively with the trauma center. To decrease late deaths, aggressive resuscitation, suitable antibiotic therapy, and conservative treatment are important.
Cause of Death ; Head ; Hemorrhage ; Humans ; Korea ; Mortality ; Motor Vehicles ; Nervous System ; Resuscitation ; Retrospective Studies ; Risk Factors ; Spine ; Tertiary Care Centers ; Thorax ; Trauma Centers

OBJECTIVE: This study was designed to evaluate the effect of the introduction of picture archiving and communication system(PACS) by identifying the change of the interpretation rates of radiologic examinations. METHODS: The data about total of 297,314 radiologic examinations done from June, 2001 to June 2002 was collected through medical record. December, 2001 which was the month of PACS introduction was excluded from the analysis for controlling the bias. Data concerning the time spent on interpretation, types of patients, clinical departments and types of radiologic examinations were collected. Chi-square test was performed to evaluate differences before and after introduction of PACS. RESULTS: 1. The interpretation rates of total radiologic examinations significantly increased after the introduction of PACS. The interpretation rate within 1 day increased 2.3 times higher after the introduction of PACS. 2. Both of the interpretation rates of radiologic examinations for outpatients and inpatients were significantly increased after the introduction of PACS. The interpretation rate within 1 day of radiologic examinations among outpatients increased 2.1 times higher and that among inpatients increased 3 times higher after the introducton of PACS. CONCLUSION: There was overall increase of interpretation rate suggesting the improvement of performance in department of radiology. This indicated that introduction of PACS brought about a positive impact on medical service quality through improving operational efficiency.
Bias (Epidemiology) ; Humans ; Inpatients ; Medical Records ; Outpatients

BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services

PURPOSE: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. METHODS: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. RESULTS: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). CONCLUSIONS: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.
Anti-Infective Agents ; Child ; Critical Illness* ; Diagnosis ; Humans ; Korea ; Lung Diseases ; Male ; Mortality ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Retrospective Studies* ; Seoul ; Stenotrophomonas maltophilia* ; Stenotrophomonas* ; Ventilators, Mechanical

Background: Lipopolysaccharide (LPS) exerts cytotoxic effects on brain cells, especially on those belonging to the oligodendrocyte lineage, in preterm infants. The susceptibility of oligodendrocyte lineage cells to LPS-induced inflammation is dependent on the developmental stage. This study aimed to investigate the effect of LPS on oligodendrocyte lineage cells at different developmental stages in a microglial cell and oligodendrocyte coculture model. Methods: The primary cultures of oligodendrocytes and microglia cells were prepared from the forebrains of 2-day-old Sprague–Dawley rats. The oligodendrocyte progenitor cells (OPCs) co-cultured with microglial cells were treated with 0 (control), 0.01, 0.1, and 1 µg/mL LPS at the D3 stage to determine the dose of LPS that impairs oligodendrocyte differentiation. The co-culture was treated with 0.01 µg/mL LPS, which was the lowest dose that did not impair oligodendrocyte differentiation, at the developmental stages D1 (early LPS group), D3 (late LPS group), or D1 and D3 (double LPS group). On day 7 of differentiation, oligodendrocytes were subjected to neural glial antigen 2 (NG2) and myelin basic protein (MBP) immunostaining to examine the number of OPCs and mature oligodendrocytes, respectively. Results: LPS dose-dependently decreased the proportion of mature oligodendrocytes (MBP+ cells) relative to the total number of cells. The number of MBP+ cells in the early LPS group was significantly lower than that in the late LPS group. Compared with those in the control group, the MBP+ cell numbers were significantly lower and the NG2+ cell numbers were significantly higher in the double LPS group, which exhibited impaired oligodendrocyte lineage cell development, on day 7 of differentiation. Conclusion Repetitive LPS stimulation during development significantly inhibited brain cell development by impairing oligodendrocyte differentiation. In contrast, brain cell development was not affected in the late LPS group. These findings suggest that inflammation at the early developmental stage of oligodendrocytes increases the susceptibility of the preterm brain to inflammation-induced injury.