PURPOSE: The purpose of this study was to identify awareness and knowledge about hepatitis B virus (HBV) infection among North Korean immigrants who had resided in South Korea. METHODS: This was a cross-sectional, community based study. Data were collected from a convenience sample of 198 North Korean immigrants aged 18 years old through 65 years old among those who had attended community centers, local churches, and gathering places in four cities. The questionnaire included 15 items about participants' knowledge on HBV infection and its consequences, mode of transmission, and preventive measures. RESULTS: The mean score of HBV knowledge was 6.3±3.8 (range 0~15). The items that over 60% of the respondents checked correct answer regarding knowledge about HBV were 'There is blood screening for hepatitis B infection', 'Hepatitis B can be transmitted through sharing needles with infected person'. Multivariate analysis showed that received education for the prevention of HBV infection and disease morbidity were significantly associated with the knowledge of HBV infection. Overall, approximately 11% of total variability in the knowledge of HBV infection could be explained by the 2 variables in this model (R²=.109, p<.001). CONCLUSION: The results showed that North Korean immigrants need more education on HBV infection and prevention to improve their knowledge about HBV.
Education ; Emigrants and Immigrants* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Screening ; Multivariate Analysis ; Needles ; Surveys and Questionnaires

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

Polypoid endometriosis is a rare form of endometriosis. It is a benign variant but its radiologic findings trick clinicians into concern about the tumor being malignant. A 42-year-old patient with a history of dysmenorrhea and adenomyosis presented a 60 mm-sized mass in the Douglas pouch with irregular echogenicity. The patient went under the first surgery for tumor removal, and its histopathologic diagnosis was endometriosis. We started daily dienogest medication to suppress tumor recurrence, but after 10 months we decided to stop the medication due to the side effects. Four months after the cessation, a new tumor recurred and after few months of observation, we performed the second surgery of tumor removal and total hysterectomy because of adenomyosis. The tumor was located in the retroperitoneal space in the Douglas pouch with severe adhesions. After the second surgery, the tumor marker Cancer antigen-125 level was normalized and the histopathologic result was endometriosis, which we concluded as polypoid endometriosis.

OBJECTIVES: The objective of this study was to evaluate an association between posttraumatic stress disorder (PTSD) and altered immunity in North Korean defectors who were more likely to develop medical conditions and other stress-related psychiatric disorders. METHODS: Twenty-four North Korean defectors with PTSD and twenty-two controls without PTSD were recruited from the resettlement and training center for North Korean defectors in South Korea. Peripheral T lymphocyte subsets, natural killer (NK) cells, NK cell activity and plasma hormones (ACTH and cortisol) were obtained from all subjects. We also applied the Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for all subjects. RESULTS: We found NK cell activity was relatively lower than number of NK cells in North Korean defectors with PTSD. Subjects with PTSD had higher HAM-D and HAM-A scores than controls. However, there were no statistical differences in ACTH, cortisol, CD3, CD4, CD8, CD4/CD8 ratio, CD19 and CD56 between the two groups. CONCLUSION: These findings suggest North Korean defectors with PTSD show higher levels of depression, anxiety and impaired or weak immune function in NK cells.
Adrenocorticotropic Hormone ; Anxiety ; Depression ; Hydrocortisone ; Killer Cells, Natural ; Plasma ; Republic of Korea ; Stress Disorders, Post-Traumatic ; T-Lymphocyte Subsets

Adult ; Anti-Bacterial Agents ; Communicable Diseases ; Debridement ; Early Diagnosis ; Extremities ; Fascia ; Fasciitis, Necrotizing ; Gangrene ; Head ; Humans ; Male ; Mortality ; Neck ; Necrosis ; Perineum ; Subcutaneous Tissue

Viagra has been prescribed worldwide to treat men with erectile dysfunction. Clinical trials have shown that Viagra may cause various kinds of adverse effects include some central nervous system (CNS) adverse effects. Although extremely rare, toxic encephalopathy also can be one of those effects. This report presents a case of encephalopathy caused by Viagra in correlation with its radiologic findings. Its pharmacologic mechanism and potential effects on the biochemistry of the CNS are reviewed.
Biochemistry ; Brain Diseases ; Central Nervous System ; Erectile Dysfunction ; Humans ; Male ; Neurotoxicity Syndromes* ; Sildenafil Citrate*

The Acknowledgements was published incorrectly. The authors apologize for any inconvenience that it may have caused.

Objective: To compare the diagnostic performance and interobserver agreement between contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CE-MRI) with magnetic resonance cholangiopancreatography (MRCP) for evaluating the resectability in patients with extrahepatic cholangiocarcinoma (eCCA). Materials and Methods: This retrospective study included treatment-naïve patients with pathologically confirmed eCCA, who underwent both CECT and CE-MRI with MRCP using extracellular contrast media between January 2015 and December 2020.Among the 214 patients (146 males; mean age ± standard deviation, 68 ± 9 years) included, 121 (56.5%) had perihilar cholangiocarcinoma. R0 resection was achieved in 108 of the 153 (70.6%) patients who underwent curative-intent surgery. Four fellowship-trained radiologists independently reviewed the findings of both CECT and CE-MRI with MRCP to assess the local tumor extent and distant metastasis for determining resectability. The pooled area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of CECT and CE-MRI with MRCP were compared using clinical, surgical, and pathological findings as reference standards. The interobserver agreement of resectability was evaluated using Fleiss kappa (κ). Results: No significant differences were observed between CECT and CE-MRI with MRCP in the pooled AUC (0.753 vs. 0.767), sensitivity (84.7% [366/432] vs. 90.3% [390/432]), and specificity (52.6% [223/424] vs. 51.4% [218/424]) (P > 0.05 for all).The AUC for determining resectability was higher when CECT and CE-MRI with MRCP were reviewed together than when CECT was reviewed alone in patients with discrepancies between the imaging modalities or with indeterminate resectability (0.798 [0.754–0.841] vs. 0.753 [0.697–0.808], P = 0.014). The interobserver agreement for overall resectability was fair for both CECT (κ = 0.323) and CE-MRI with MRCP (κ = 0.320), without a significant difference (P = 0.884). Conclusion CECT and CE-MRI with MRCP showed no significant differences in the diagnostic performance and interobserver agreement in determining the resectability in patients with eCCA.

Two autopsy cases of asphyxia due to oxygen deficiency are reported. The first case is that a 38-year-old man died in a storehouse. Many pears were stored in a storehouse and the its atmosphere was strictly controlled. The second case is that a 42-year-old man died in the boiler room of a fishing ship. Much amount of Freon gas escaped due to a defect of the refrigerator in the boiler room. The victim entered the boiler room because he repaired the refrigerator. But, the victim died when he entered the boiler room immediately. In this article, the autopsy findings and the contents of the investigation of scene of two cases are described.
Adult ; Anoxia* ; Asphyxia* ; Atmosphere ; Autopsy* ; Chlorofluorocarbons ; Humans ; Oxygen* ; Pyrus ; Ships ; United Nations

This present study aimed to investigate the association effect of obesity status, physical symptom, insecure attachment, and depression on psychological well-being in non-diabetic healthy Koreans. Height, weight, waist circumference, blood pressure, and socio-psychological questionnaires (insecure attachment, depression, and physical symptom psychological well-being, etc.) were examined in 123 healthy Koreans. Student t-test, correlation analysis, and mediation analysis were performed. Study subjects were divided into 2 groups based on body mass index (BMI, kg/m²): obesity (BMI ≥ 25, n = 36) and non-obesity (BMI < 25, n = 87). Obese people were older and showed higher proportion of males than non-obese ones. Regarding the values of socio-psychological test, obesity group showed lower insecure attachment, and higher physical symptom than non-obesity group. In correlation and mediation analyses, depression was positively related to insecure attachment and physical symptom in both BMI groups. Positive relationship between physical symptom and insecure attachment was observed only in non-obesity group, but not in obesity group. The effect of insecure attachment on psychological well-being was completely mediated by depression in both BMI groups. On the other hand, the effect of physical symptom on psychological well-being was completely mediated by depression in obesity group, but not in non-obesity group. In conclusion, this study presented that the effects of physical symptom and insecure attachment on psychological well-being were completely mediated by depression in obese healthy Koreans, but not in non-obese ones. It will provide useful data for extending the knowledge on the relationship between the physical health and mental health.
Blood Pressure ; Body Mass Index ; Depression* ; Hand ; Humans ; Male ; Mental Health ; Negotiating ; Obesity ; Waist Circumference