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

A study was made in the congenital anomalies in 137 babies born to 120 mothers with hydramnios, delivered at Ilsin Christian Hospital between Jan. 1st 1981 and Dec. 31th 1990. The results were as follows; 1) The incidence of hydramnios was 1.6/1000 deliveries, 120 cases in total 73, 129 deliveries. 137 infants was born and of these 71 (51.8%) had congenital anomalies. 2) Hydramnios was assiciated with a high incidence of prematurity and low birth weight infant. 3) The incience of multiple anomalies was 54.9% (39 out of 71 infants). The most common system involved with the congenital anomalies was the musculoskeletal system, 28.9% (39 cases out of 135) and the most frequent anomaly was anencephaly, 15 cases. 4) The perinatal mortality rate was 759/1000 total (104 cases) and of these 45 cases, 43.3% were associated with congenital anomalies. 53 of the live birth had congenital anomalies and of these 27 cases (50.9%) died in the neonatal period.
Anencephaly ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Live Birth ; Mothers ; Musculoskeletal System ; Parturition* ; Perinatal Mortality ; Polyhydramnios*

Generalized anxiety disorder (GAD) is highly prevalent psychiatric disorder in primary care population and is a source of major morbidity. However, the underawareness and undertreatment of GAD, which is due to insufficient knowledge about the disorder, often hinder the proper management of this chronic condition. Other characteristic features such as chronic course of GAD, frequent comorbidity with other anxiety and depressive disorders, and the controversy regarding the best diagnostic criteria should be fully discussed. First of all, proper and accurate diagnosis is crucial for an appropriate management. Primary care management of GAD and associated comorbidities includes education about the nature of GAD and counseling about treatment alternatives and coping strategies is an important first step. The most effective treatment of GAD is combined psychotherapeutic and pharmacotherapeutic approach. The major psychotherapeutic approaches to GAD are cognitive-behavioral therapy with relaxation techniques. Pharmacological treatment for GAD includes benzodiazepine, buspirone, and antidepressants. In this review, these combined treatment at the view point of primary practitioners was described.
Antidepressive Agents ; Anxiety Disorders* ; Anxiety* ; Benzodiazepines ; Buspirone ; Comorbidity ; Counseling ; Depressive Disorder ; Diagnosis* ; Education ; Primary Health Care ; Relaxation Therapy

PURPOSE: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. MATERIALS AND METHODS: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of > or = 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). RESULTS: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (P<0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). CONCLUSION: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.
Arteries ; Artifacts ; Breast ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: Transcranial magnetic stimulation (TMS) is a novel, noninvasive method of brain stimulation. As the knowledge of the neuroanatomical abnormalities of posttraumatic stress disorder (PTSD) has been increased, therapeutic application of TMS has been suggested in patients with PTSD. Thus we reviewed the literatures to look into the effectiveness of TMS for the treatment of PTSD. METHODS: We described the published clinical studies of TMS in patients with PTSD using literature review and our preliminary results of clinical trial for integrating the future direction of TMS research in the treatment of PTSD. RESULTS: Although the previous studies for the treatment of PTSD were scanty, TMS might be an tolerable and safe option for the intervention of PTSD. Several studies suggested that repeated rhythmic TMS (rTMS) to right prefrontal cortex might be useful for the treatment of PTSD. The accurate mechanism of rTMS has not been known yet. However, it is supposed that rTMS may have the ability to normalize brain metabolism, improve neuronal functional connectivity and modulate the neuronal circuitry in patients with PTSD. This capability has raised the possibility of the use of rTMS as a novel therapeutic tool for PTSD. CONCLUSION: In order to optimize rTMS for therapeutic use in PTSD, it is necessary to determine rTMS treatment parameters, such as frequency, intensity, pulse duration and stimulation site, pulse width, intertrain interval, coil type, numbers of sessions, and interval between sessions. rTMS would be a relatively new and noninvasive method for exploring the regional brain circuitry of PTSD.
Brain ; Humans ; Metabolism ; Neurons ; Prefrontal Cortex ; Stress Disorders, Post-Traumatic* ; Transcranial Magnetic Stimulation*

Hypertension is a risk factor for developing fatal aortic dissection. Aortic dissection occurs 2~3 times as often in men than in women between ages of 50~70 years old. Among other risk factors, aortic dissection occurs especially in women below the age of 40 years old in pregnancy-related cases. In pregnancy-related cases, aortic dissection occurs in the third trimester and in puerperium, as well as in multiparous women. The writers experienced an aortic dissection related pregnancy. The patient was 32 years old, diagnosis of dissection occurred in the postpartum period. Although, aortic dissection is a rare complication of pregnancy, the knowledge of this may assist the emergency physician save the lives of patients.
Adult ; Diagnosis ; Emergencies ; Female ; Humans ; Hypertension ; Male ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Third ; Risk Factors

The purpose of this study was to examine the mediating effects of sense of coherence and social support in the relationship between uncertainty and health-related quality of life (HRQoL) in elderly patients who underwent with total knee arthroplasty. Methods: A descriptive study was conducted with 186 patients who underwent total knee arthroplasty. Data were collected from September 17 to October 16, 2019 through structured questionnaires and analyzed with descriptive statistics, the independent t-test, one-way analysis of variance, Pearson correlation coefficients, and a parallel redundant mediated model in the PROCESS macro using SPSS version 27.0. Results: The mean scores of uncertainty, sense of coherence, social support, and HRQoL were 100.72, 49.77, 93.77, and 41.61. The direct effect of uncertainty on HRQoL and the indirect effect of uncertainty, mediated by sense of coherence and social support, on HRQoL were statistically significant. Conclusion: These results indicate that in order to increase the HRQoL of elderly patients who undergo total knee arthroplasty, it is necessary to develop an intervention program that focuses both on reducing uncertainty and on improving patients’ sense of coherence and social support.

We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed.
Neck ; Neoplasm Metastasis ; Salivary Gland Calculi* ; Submandibular Gland ; Thyroid Gland* ; Thyroid Neoplasms*

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.
Aged ; Brain ; Decision Making* ; Drainage ; Emergencies ; Female ; Heart Ventricles ; Humans ; Hydrocephalus ; Lymphangioma, Cystic ; Neurosurgery ; Pentetic Acid ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Subdural Effusion* ; Ventriculoperitoneal Shunt