OBJECTIVES: This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. METHODS: Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. RESULTS: Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. CONCLUSIONS: This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to Bpromote adherence to hand washing.
Adolescent ; Adult ; Child ; Female ; *Handwashing ; *Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; Toilet Facilities

Fetal cystic hygroma is a congenital malformation of the lymphatic system resulting from the jugular-lymphatic obstruction sequence. This is characterized by single or multiple cysts within the soft tissues, usually involving the neck and is easily diagnosed by prenatal ultrasonography. We report a case of axillary cystic hygroma which was diagnosed by ultrasonography at 25 weeks of gestation with a brief review of related literatures.
Lymphangioma, Cystic* ; Lymphatic System ; Neck ; Pregnancy ; Prenatal Diagnosis* ; Ultrasonography ; Ultrasonography, Prenatal

Background: We investigated the effects of sevoflurane exposure on the expression of matrix metalloproteinase (MMP), expression and ablation of natural killer group 2, member D (NKG2D) ligands (UL16-binding proteins 1–3 and major histocompatibility complex class I chain-related molecules A/B), and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells. Methods: Three human breast cancer cell lines (MCF-7, MDA-MB-453, and HCC-70) were incubated with 0 (control), 600 (S6), or 1200 μM (S12) sevoflurane for 4 h. The gene expression of NKG2D ligands and their protein expression on cancer cell surfaces were measured using multiplex polymerase chain reaction (PCR) and flow cytometry, respectively. Protein expression of MMP-1 and -2 and the concentration of soluble NKG2D ligands were analyzed using western blotting and enzyme-linked immunosorbent assays, respectively. Results: Sevoflurane downregulated the mRNA and protein expression of the NKG2D ligand in a dose-dependent manner in MCF-7, MDA-MB-453, and HCC-70 cells but did not affect the expression of MMP-1 or -2 or the concentration of soluble NKG2D ligands in the MCF-7, MDA-MB-453, and HCC-70 cells. Sevoflurane attenuated NK cell-mediated cancer cell lysis in a dose-dependent manner in MCF-7, MDA-MB-453, and HCC-70 cells (P = 0.040, P = 0.040, and P = 0.040, respectively). Conclusions Our results demonstrate that sevoflurane exposure attenuates NK cell-mediated cytotoxicity in breast cancer cells in a dose-dependent manner. This could be attributed to a sevoflurane-induced decrease in the transcription of NKG2D ligands rather than sevoflurane-induced changes in MMP expression and their proteolytic activity.

OBJECTIVES: This study aimed at clarifying the character of cerebral artery vasospasm on rabbit model by observing the vascular responses to nitric oxide and endothelin-1 treatment at different time points. MATERIALS AND METHODS: Twenty-eight rabbits undertook vertebrobasilar angiographies on the postoperative 2nd day and the 7th day after subarachnoid hemorrhage operation. The animals were divided into the vasospasm and the non-vasospasm group accroding to the result of vertebrobasilar angiographies. After sacrificing the animal, the vascular ring of harvested basilar artery was suspended in Krebs solution organ chamber for observation of isometric tension change in response to nitric oxide (NO) and endothelin-1 under high (95% O2 / 5% CO2) and low (95% N2 / 5% CO2) O2 tension. To investigate NO-dependent the vascular relaxation response, acetylcholine (10-7-3x10-4 M) was applied to basilar artery ring preconcentrated with histamine (10-6-10-5 M) in the organ chamber. The vascular contraction response was observed by applying endothelin-1 (10-11-3x10-8 M) into the organ chamber. RESULTS: The angiography showed vasospasm in seven of fifteen rabbits of the postoperative-2-day group (64.3+/-11.2%) and seven of fifteen rabbits of the postoperative-7-day (64.9+/-10.9%). On the postoperative-2-day, all the vascular response to NO and endothelin-1 under both high and low O2 tension was not significantly different between the vasospasm developed basilar artery and the vasospasm undeveloped one. On the postoperative-7-day, the vascular relaxation response to NO under high O2 tension was significantly different between the vasospasm developed basilar artery and the vasospasm undeveloped one (p=0.029). However, the vascular relaxation response to NO under low O2 tension was not significantly different. The vascular contraction response to endothelin-1 under high O2 tension was significantly different between the vasospasm developed basilar artery and the vasospasm undeveloped one (p=0.032). However, the vascular contraction response to endothelin-1 under low O2 tension was not significantly different. CONCLUSION: This experiment suggest that the vasospasm of the postoperative-2-day have different character from that of the postoperative-7-day in the rabbits. This suggestion may play some roles in the future study of the subarachnoid hemorrhage model. the study of the vasospasm mechanism of human, and developing antispasmodic drugs.
Acetylcholine ; Angiography ; Animals ; Basilar Artery* ; Cerebral Arteries ; Endothelin-1* ; Histamine ; Humans ; Nitric Oxide* ; Parasympatholytics ; Rabbits ; Relaxation ; Subarachnoid Hemorrhage

BACKGROUND: Studies on the relationship between vitamin D and visceral fat area (VFA; intra-abdominal fat area) have been actively conducted. But, there is a few Korean population-based studies about the association between serum vitamin D level and VFA. The aim of our study was to explore the correlation between serum 25-hydroxyvitamin D (25[OH]D) levels and VFA measured using bioelectrical impedance analysis (BIA; electric impedance) in healthy Korean adults. METHODS: This cross-sectional study involved 1,945 adults aged 20-70 years who visited a health promotion center. All subjects underwent the BIA to estimate the VFA. Serum 25(OH)D level was measured using chemiluminescent immunoassay. Multiple regression analysis was performed to identify independent correlation of VFA and serum 25(OH)D level. RESULTS: The prevalence of vitamin D deficiency (25[OH]D: 20-29 ng/mL) and insufficiency (25[OH]D <20 ng/mL) were 54.4% and 38.1%, respectively. After having adjusted age and season, VFA were negatively associated with serum 25(OH)D levels in both men (P<0.001) and women (P<0.001). The obese group with VFA ≥ 100 cm² had significant lower serum 25(OH)D level in men (P<0.001) and women (P=0.0034). CONCLUSIONS: VFA measured using BIA could be negatively associated with serum 25(OH)D levels in healthy Korean adult.
Adult* ; Cross-Sectional Studies ; Electric Impedance ; Female ; Health Promotion ; Humans ; Immunoassay ; Intra-Abdominal Fat* ; Male ; Obesity ; Prevalence ; Seasons ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

BACKGROUND: Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density and skeletal microstructural abnormalities. We investigated the correlation between serum uric acid (SUA) levels and bone mineral content (BMC) values as a surrogate marker of bone health. Additionally, we assessed whether the correlation, if any, was evident even after classifying the study population into two groups based on a diagnosis of obesity in these individuals.METHODS: This study included 936 women who visited the healthcare centers that participated in this study. Fasting blood samples were obtained from all women to measure SUA, BMC of the lumbar spine was measured using dual-energy X-ray absorptiometry. We evaluated the correlation between SUA and BMC in obese and non-obese groups.RESULTS: SUA concentration and BMC were positively correlated (β=0.257, P=0.001); however, this correlation was significant only in the obese group (β=0.203, P=0.001).CONCLUSION: SUA concentration and BMC are positively correlated in women diagnosed obesity.
Absorptiometry, Photon ; Biomarkers ; Body Mass Index ; Bone Density ; Delivery of Health Care ; Diagnosis ; Fasting ; Female ; Humans ; Obesity ; Osteoporosis ; Spine ; Uric Acid

Background: Body mass index (BMI) has limitations in determining body fat percentage and body fat distribution, and causes misclassification of body fat-defined obesity. As high body fat percentage is associated with mortality, an accurate assessment of body fat percentage is considered clinically important. Recently, Woolcott and Bergman reported a relative fat mass (RFM) equation which calculated the body fat percentage using the height and waist circumferences. However, as RFM has been studied only in European-, Mexican-, and African-Americans, an assessment in Asians was needed. Therefore, we aimed to evaluate the applicability of RFM in Korean adults. Methods: This study included 7,733 adults who visited a Sanggye Paik Hospital Health Promotion Center from May 1, 2016 to November 12, 2018. BMI and RFM were calculated by measuring height, weight, and waist circumference. The total body fat (TBF) percentage was measured by bioelectrical impedance analysis. We compared the BMI, RFM, and TBF percentage to assess the applicability of RFM in Korean adults. Results: RFM had a statistically significant correlation with TBF percentage in both male and female (male: β=0.808, R2=0.653, female: β=0.766, R2=0.587, P<0.001). In the Bland-Altman plot, RFM showed good agreement with the TBF percentage within the 95% confidence interval. Conclusion The RFM equation can be used to predict TBF percentage in Korean adults.

Background: Previous studies have shown that elevated ferritin level and neutrophil to lymphocyte ratio (NLR) are risk factors of chronic low-gradeinflammation and contribute to the onset and progression of cardiovascular disease. In addition, metabolic syndrome has a similar relevance; thus,in this study, we aimed to determine how well metabolic syndrome could be predicted by measuring ferritin level and NLR. Methods: From January 2016 to September 2018, 1,815 adults who underwent medical interviews, physical measurements, and blood tests at amedical examination center of a university hospital in Seoul were evaluated. Data were analyzed using the Spearman correlation analysis, anaverage comparison using analysis of variance, and a t test. The prevalence of metabolic syndrome was determined according to ferritin level andNLR. Results: We found a significant correlation between the components of metabolic syndrome and ferritin level, but not NLR. The NLRs were divided intoquartiles for comparison with the mean values of the components of metabolic syndrome, but the results were not significant. A significantdifference was found only in ferritin level when we compared the mean values of ferritin level and NLR according to the presence or absence of ametabolic syndrome diagnosis. When ferritin level and NLR were considered simultaneously, the prevalence of metabolic syndrome tended tochange only when the ferritin level changed. Conclusion In healthy Korean adults, ferritin level, but not NLR, could be used as a predictor of metabolic syndrome.

Background: To analyze the effects of socioeconomic status (type of insurance and income level) and cancer stage on the survival of patients with liver cancer in Korea. Methods: A retrospective cohort study was constructed using data from the Healthcare Big Data Platform project in Korea between January 1, 2007, and December 31, 2017. A total of 143,511 patients in Korea diagnosed with liver cancer (International Classification of Diseases, 10th Revision [ICD-10] codes C22, C220, and C221) were followed for an average of 11 years. Of these, 110,443 died. The patient’s insurance type and income level were used as indicators of socioeconomic status. Unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards regression model to analyze the relationship between the effects of sex, age, and cancer stage at first diagnosis (Surveillance, Epidemiology, and the End Results; SEER), type of insurance, and income level on the survival of patients with liver cancer. The interactive effects of the type of insurance, income level, and cancer stage on liver cancer death were also analyzed. Results: The lowest income group (medical aid) showed a higher risk for mortality (HR (95% CI); 1.37 (1.27–1.47) for all patients, 1.44 (1.32–1.57) for men, and 1.16 (1.01–1.34) for women) compared to the highest income group (1–6) among liver cancer (ICD-10 code C22) patients. The risk of liver cancer death was also higher in the lowest income group with a distant cancer stage (SEER = 7) diagnosis than for any other group. Conclusion Liver cancer patients with lower socioeconomic status and more severe cancer stages were at greater risk of death. Reducing social inequalities is needed to improve mortality rates among patients in lower social class groups who present with advanced cancer.

BACKGROUND: An important metabolic feature of acromegaly is a reduced action of insulin on hepatic gluconeogenesis and peripheral glucose disposal which mediated by growth hormone hypersecretion. Octreotide, a synthetic octapeptide somatostatin analogue exerts complex effects on hormonal and metabolic regulations affecting glucose homeostasis. This study was designed to ascertain the shorterm effect of octreotide on glucose tolerance in acromegaly. METHODS: 10 patients (five men and five women, age 47.9+/-11.8) were injected subcutaneously with octreotide, 100 micrograms for 24 hours. Patients were assessed with respect to growth hormone, glucose, and insulin response to a standard 100 g oral glucose tolerance test (OGTT) before and during the last 2 hour of octreotide infusion. RESULTS: During the therapy, there was significant decrease in mean blood glucose response to OGTT (678.4+/-51.9 vs 581.9+/-47.3 mg/dL/2hr: mean areas under the glucose curve, p=0.01) and mean serum insulin response to oral glucose load was significantly reduced in all patients (339.2+/-106.2 vs 256.7+/-111.3 U/mL/2hr: mean areas under the insulin curve, p=0.01). Using glucose tolerance test criteria three patients of 10 had normal glucose tolerance, four and three had impaired glucose tolerance and diabetes, respectively, at base line. While on octreotide these composition was changed to six patients of NGT, three of IGT and one diabetes. CONCLUSION: We conclude that insulin resistance mediated by GH hypersecretion was improved by shorterm octreotide treatment.
Acromegaly* ; Blood Glucose ; Female ; Gluconeogenesis ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Homeostasis ; Humans ; Infusions, Subcutaneous* ; Insulin ; Insulin Resistance ; Male ; Octreotide* ; Social Control, Formal ; Somatostatin