BACKGROUND: This study was performed to find out about the factors related to administration of hormone replacement therapy (HRT) in postmenopausal women. METHODS: One thousand seventy three postmenopausal women living in Busan and Kimhae were surveyed from August, 2000 to February, 2001. The subjects were asked whether they were receiving the HRT or not and about several factors that have known to be related to receiving the HRT. RESULTS: Among the total, 16.3% of women were current users, 12.4% were ex-users, and 71.2% were non-users. There were significant differences in age, marital status, number of children, education level, and income among the three groups. The proportions of hysterectomy and health-related behaviors were higher among current and ex-users than non-users. The current users were receiving the HRT by continuous combination method rather than cyclic therapy. Among them, 70% responded 'physician's recommendation' as the main reason for receiving the HRT. Among the current users 48% responded 'improved general condition' for receiving as the main reason the HRT currently. However, 29% of ex-users stopped therapy because of side effects. Among non-users 55% have not been provided with information about the HRT. Women having regular exercise at least once a week were 3.5 times more likely to be current users (95% C.I.: 1.3~9.6). One year after menopause women were 1.2 times (95% C.I: 1.0~1.4) more likely to be current users. CONCLUSION: Postmenopausal women who exercised regularly and experienced menopause at an older age seemed to be more likely current users. Therefore, women having such characteristics may need more adequate information about the HRT.
Busan ; Child ; Education ; Female ; Gyeongsangnam-do ; Hormone Replacement Therapy* ; Humans ; Hysterectomy ; Marital Status ; Menopause

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.
Asian Continental Ancestry Group ; Female ; Fingers ; Hand ; Humans ; Male ; Reference Values ; Thumb

LPS and IFN-r induce nitric oxide synthase in macrophages and the resultant NO causes apoptotic cell death in the activated macrophages. NO production and apoptosis were inhibited by N-monomethyl L-arginine (NMMA), a competitive inhibitor of NO synthase. To study the role of BCL-X proteins, RAW 264.7 cells were transfected with the expression vectors with human bcl-Xl or bcl-Xs cDNAs, respectively. Stable transfectants were selected and confirmed by RT-PCR. NO production in response to LPS and IFN-r caused apoptosis in RAW 264.7 cells and vector transfected control cells within 24 hr. Both NO production and apoptosis were inhibited by N(G)-monomethyl L-arginine (NMMA). In contrast, bcl-Xs transfectant appeared slightly susceptible and bcl-X(L)< transfectant appeared slightly resistant, although NO production was similar to control cells. These results suggest that bcl-X proteins play roles in both positive and negative regulation of apoptosis induced by NO.
Apoptosis* ; Arginine ; bcl-X Protein* ; Cell Death ; DNA, Complementary ; Humans ; Macrophages* ; Nitric Oxide ; Nitric Oxide Synthase

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

Epilepsy can be divided into idiopathic epilepsy and symptomatic epilepsy according to the existence ofunderlying organic disease. It has been said that the incidence of the symptomatic epilepsy caused by underlyingorgainic brain disease is higher in late-onset epilepsy after the age of 20 than in childhood-onset epoilepsy. CTis very sensitive and non-invasive method for detection of organic brain disease. 168 cases of late-onset epilepsyafter the age of 20 were studied by CT in recent 2 years were analyzed. The results were as follows; 1. The 3rddecade was the most frequent age group, and the ratio of male to female was 2.5;1. 2. Structural abnormality onbrain CT was demonstrated in 51.8% of hte patient. 3. The older the onset of age was, the higher the rate of theabnormal CT finding, except 5th decade which showed less CT abnormality than 4th decade. 4. The most frequenthistory related to epilepsy was trauma. 63.1% of the patients had no relevant history; and they showed CT findingsof brain tumor, atrophy and infarction in decreasing order of frequency. 5. Abnormal CT finding was demonstratedin 49.2% of normal neurologic examination and in 46.4% of normal EEG study. 6. The most frequent lesion ofabnormal CT scan in late-onset epilepsy was 30 cases(18.4% )of brain atrophy. The next frequent lesion was 18cases (10.7%) of brain tumor. Infarction, parasites and calcification were other frequnet lesions.
Atrophy ; Brain ; Brain Diseases ; Brain Neoplasms ; Electroencephalography ; Epilepsy ; Female ; Humans ; Incidence ; Infarction ; Male ; Methods ; Neurologic Examination ; Parasites ; Tomography, X-Ray Computed

Brain size is a useful parameter describing ontogenic character and function. Despite its potential contribution to functional study and diagnosis of disease, it has been hampered by poor assessment tools in vivo and postmortem changes. Recent development of medical imaging techniques such as MRI and CT enable us to understand brain structures in vivo. Many morphometirc studies of the brain has given us new insights in the field of functional neuroanatomy and neuropsychiatric diseases. In spite of these advances, volumetric data of normal Korean brain is not available yet. As an initial approach to Korean standard brain size, we measured the cerebellar volume between 20 and 80 years old Koreans. The MRI films free from lesions in brain was analyzed and measured by NIH image program. The Korean cerebellar volume were ranged between 86.2cm(3) and 141.3 cm(3) and average male cerebellum volume was significantly larger than that of female[male : 118.2+/-11.2cm(3)] > female : 108.0+/-9.6cm(3), P=0.1021E-07<0.05]. And we could not find volume change according to aging process. This is the first report on normal Korean cerebellar volume and the presence of gender difference in the Korean cerebellar volume. These data will be used for the standard useful in studying cerebellar function and cerebellum associated disorders in the future.
Aged, 80 and over ; Aging ; Brain ; Cerebellum ; Diagnosis ; Diagnostic Imaging ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Neuroanatomy ; Postmortem Changes

Purpose: This study aimed to report the projected cancer incidence and mortality for the year 2022 to estimate Korea’s current cancer burden. Materials and Methods: Cancer incidence data from 1999 to 2019 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2020 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and then by multiplying the projected age-specific rates by the anticipated age-specific population for 2022. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend. Results: In total, 274,488 new cancer cases and 81,277 cancer deaths are expected to occur in Korea in 2022. The most common cancer site is expected to be the thyroid, followed by the lung, colon and rectum, breast, and stomach. These five cancers are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and gallbladder cancers. Conclusion The incidence rates for all types of cancer in Korea are estimated to gradually decrease. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

A malignancy is a fatal condition that could occur through various mechanisms. Forensic pathologists sometimes find unexpected findings during autopsy and post-mortem (PM) tests. Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. The deceased was a 64-year-old man with a medical history of right hemicolectomy due to colon cancer approximately two years earlier. He was found dead at his home. He was admitted to the hospital due to subdural hemorrhage (SDH) two days prior to his demise and was discharged without the permission of the doctor after one day of hospitalization. An autopsy was performed within two days of his death. After gross dissection, the cause and manner of death were assumed to be SDH and unnatural death, respectively. Microscopic examination revealed fresh SDH and dural metastasis of signet-ring cell carcinoma. Furthermore, metastasis was identified in the heart, stomach, and peritoneum. Immunohistochemical examination revealed cancer cells to originate from the colon. After meticulous PM examination, including gross dissection, microscopic examination, PM computed tomography, and PM laboratory tests, the cause and manner of death were determined as SDH and natural death, respectively. This case report highlights the importance of comprehensive PM evaluation for investigating death.

Endoscopic mucosal resection (EMR) has been standardized for the treatment of intestinal type of intramucosal gastric carcinomas, and careful histological examination of the resected specimen is important for further treatment. To evaluate the diagnostic utility of p53 expression in gastric EMR samples, using immunohistochemical staining, we examined 24 gastric carcinomas (22 intestinal types and two diffuse types) and 20 adenomas removed by EMR. Intestinal type of adenocarcinomas revealed strong p53 expression in 13 cases (59%), weak in four cases (18%), and negative in five cases (23%). Resection margins of 11 carcinomas were involved in the carcinoma cells, which showed the same p53 expression pattern with main carcinoma cells. Squeezed carcinoma cells, remaining in resection margins, were definitely identified by strong p53 expression in seven cases of which the main tumor strongly expressed p53. Microscopic in situ carcinoma could be easily detected in p53 immunostaining. Multifocal involvement and submucosal invasion of carcinomas could be demarcated easily and definitely by strong p53 expression of carcinoma cells. All adenomas showed diffuse weak p53 expression. The difference of p53 expression (p< 0.001) could be used as a differential diagnosis between adenomas and carcinomas. According to these results, we propose that for careful histological examination in hospital diagnosis, both histological evaluation and p53 immunostaining are important diagnostic parameters in EMR samples of the intestinal type of gastric carcinomas.
Adenocarcinoma/surgery ; Adenocarcinoma/pathology ; Adenoma/surgery* ; Adenoma/pathology* ; Endoscopy* ; Gastric Mucosa/metabolism ; Gastric Mucosa/chemistry ; Human ; Immunoenzyme Techniques ; Protein p53/diagnostic use* ; Protein p53/biosynthesis ; Protein p53/analysis ; Stomach Neoplasms/surgery* ; Stomach Neoplasms/pathology* ; Tumor Markers, Biological

Tethered cord syndrome is a symptom complex result from tightening of film terminale. Thickened filum terminale, lipomyelomeningocele, diastematomyelia, dermal sinus tract, intradural fibrous adhesion, and spinal lipoma might cause the tightening. The common mechanism of these injury is suggested an impairment of longitudinal movement of the sinal cord, especially conus medullaris, which subsequently leads to chronic local ischemia. During cadaver dissection, we have observed low conus medullaris (L4) and thickened film terminale with intradural lipoma in 51 years old female. Thickened film terminale merged into lipomtous cyst located in lower marin of sacral canal. These morphologic findings is considered a lipomatous film terminale, which might cause tethered syndrome.
Cadaver* ; Cauda Equina* ; Conus Snail ; Female ; Humans ; Ischemia ; Lipoma ; Middle Aged ; Neural Tube Defects ; Spina Bifida Occulta