No abstract available.
Health Promotion* ; Primary Health Care*

Cigarette smoking is the most important preventable cause of death in Korea. Smoking should be considered as a chronic disease attributed to nicotine dependence which needs a long term care. Nicotine dependence and withdrawal symptoms are major barriers to smoking cessation and can be successfully managed by pharmacotherapy. There are two types of pharmacotherapy for nicotine dependence, nicotine-replacement therapy(NRT) and nonnicotine-replacement therapy. Nicotine, which can be administered by patch, gum, inhaler, and nasal spray, doubled the smoking cessation rate. NRTs are usually well tolerated. Sustained-release bupropion, an antidepressant, doubled the smoking cessation rate when combined with counselling. Bupropion can induce seizure in less than 0.1% by lowering the seizure threshold. Nortriptyline and clonidine can be used as second line drugs for smoking cessation. They are similar in efficacy compared to NRT or bupropion but they frequently have adverse drug reactions. Combination of bupropion with NRT is more efficacious than NRT alone but not more effective than bupropion alone. There is no convincing evidence to recommend a specific drug for smoking cessation in women. NRT and bupropion can be useful in special situations for adolescent smokers, but evidence is not enough to recommend pharmacotherapy for adolescent smokers. Weight gain is the main barrier to smoking cessation, especially in women. Vigorous exercise reduced weight gain. Nicotine gum, bupropion also temporarily reduced weight gain after smoking cessation, but only while the drug was being administered. As there are sound evidences for the effect of pharmacotherapy in smoking cessation, it is necessary for physicians to integrate it into their daily practices.
Adolescent ; Bupropion ; Cause of Death ; Chronic Disease ; Clonidine ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Female ; Gingiva ; Humans ; Korea ; Long-Term Care ; Nebulizers and Vaporizers ; Nicotine* ; Nortriptyline ; Seizures ; Smoke ; Smoking ; Smoking Cessation ; Substance Withdrawal Syndrome ; Tobacco Use Disorder* ; Weight Gain

No abstract available.
Stomach Neoplasms* ; Tomography, X-Ray Computed*

Scleredema is a rare skin disease of unknown cause involving the face, neck, upper portion of the trunk, and proximal upper extremities. The clinical features of it are nonpitting, solid emema or stiffness of the neck, which may be sudden or insidious onset. Preceeding upper respiratory infection or diabetes mellitus have been frequently discribed to be associated with the disease. A monoclonal gammopathy has been frequently observed in patients with scleredema. We present a case of scleredema developed the face, upper portion of the back and shoulder in 16-year-old girl who had a preceeding upper respiratory infection.
Adolescent ; Diabetes Mellitus ; Female ; Humans ; Neck ; Paraproteinemias ; Scleredema Adultorum* ; Shoulder ; Skin Diseases ; Upper Extremity

BACKGROUND: This study was performed to determine and compare the practice patterns of management of hypertension of the internists and family physicians in general hospitals and to compare them according to the JNC V guidelines. METHODS: Questionnaires were mailed to total 964 of internists and family physicians in general hospitals during May, 1996. 217 of them were returned with the response rate of 23.5%. Chi-square test and Fishers exact test were performed to examine the statistical difference between two groups. RESULTS: The mean age of the respondents was 39.1 and 77.9% of them were male. 65.4 % of hospitals for respondents were located in metropolitan cities. Concerning the number of measurements of blood pressure, 0.5% of the respondents measured just once before confirmation of the diagnosis. Items for physical examinations for initial evaluation were as follows; cardiac auscultation(94.0%), measurements of body weight and height(58.9%), abdominal examination(52.8%), auscultation for carotid bruit(41.7%), fundoscopic examination (25.6%). Regarding the laboratory tests, the frequency of evaluation of all item were higher than that of the physical examinations. For initial drug therapy, calcium channel blockers and ACE inhibitors were the most frequently chosen mediations. No difference was found between two specialties or tertiary and secondary hospitals in this trend. With educations for the life-style modification, 60-80% of the respondents educated the patients. No difference was found between two specialties except one item. CONCLUSIONS: As a whole the JNC V guidelines were not followed faithfully for the management of hypertension.
Angiotensin-Converting Enzyme Inhibitors ; Auscultation ; Blood Pressure ; Body Weight ; Calcium Channel Blockers ; Surveys and Questionnaires ; Diagnosis ; Drug Therapy ; Hospitals, General* ; Humans ; Hypertension* ; Male ; Physical Examination ; Physicians, Family* ; Postal Service ; Surveys and Questionnaires

Tbe presence of certain HPV types in the female genital tract was associated with a number of diseases, including condyloma, cervical, vaginal and vulvar intraepithelial neoplasia and carcinoma. It is generally accepted that these viruses are predominantly sexually transmitted. HPV cannot be cultured in vitro, and immunological tests are inadequate. Indirect evidence of anogenital HPV infection can be obtained through the physical examination and by the presence of characteristic cellular changes associated with viral replication in Pap smear or biopsy specimens. Alternately cervical scrapes can be analyzed by nucleic acid hybridization to directly detect the presence of HPV DNA, Historically, HPV 16 and HPV 18 have been regarded as high risk cancer associated HPVs and HPV types 6, 11, 42, 43 and 44 as low risk HPVs. Subsequently HPV types 31, 33, 34, 35, 45, 51, 52, 56 and 58 have been demonstrated to have and intemediate association with cancer, This study was performed for high and intermediate types HPV DNA detection on cervical carcinoma with Virapap Probe B. HPV DNA were detected 82.3% on cervical carcinoma and 7,1% on control samples. HPV DNA test will be apply as a triage for cervical cancer detecting test.
Biopsy ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Human Papillomavirus DNA Tests ; Humans* ; Immunologic Tests ; Nucleic Acid Hybridization ; Papilloma* ; Physical Examination ; Triage ; Uterine Cervical Neoplasms*

We have observed that many patients who were under the treatment of orient medicine at the emergency department of our hospital but no data are available describing the medical habits of these patients. We therefore surveyed these patients seeking care in our ED to characterize their use of orient-medical therapies.4 analysis on the 427 patients who visited our ED and were under the treatment of orient medicine from Jan. 1996 to Jun. 1996 was carried out The results were as follows 1) There was no difference in the sex ratio (m:f=1:0.93). 2) With respect to the age groups of in patients, feat numbers of elderly people(50-year and 60-year old age group, over 60%) visited to our ED. 3) In the leading causes for visit to orient-medical therapy, cardiovascular disease ranked at the top(40%), followed by injury, gastrointestinal disease, and respiratory disease in decreasing order of frequency.4) The total numbers of CVA patients admitted to Oriental medicine were 105 patients. 5) The duration of admitted patients to Oriental medicine was prolonged for elderly patients.6) In the distribution of severity(AVPU) of adimitted patients, the number of patients with alert was 12 and verbal response was 91 painful response was 2 and unresponse was 0.
Aged ; Cardiovascular Diseases ; Emergencies* ; Emergency Service, Hospital* ; Gastrointestinal Diseases ; Humans ; Medicine, East Asian Traditional ; Middle Aged ; Sex Ratio

No abstract available.
Hepatitis B* ; Hepatitis* ; Vaccination*

Among the efficient cancer treatments, photodynamic therapy (PDT) is one of the therapies inducing rapid apoptosis of cancer cells while causing minimal damage to surrounding normal tissue. We studied the effect of PDT on the adenocarcinoma in BALB/-c mice of homograft model, and the following results were obtained. Apoptosis occurred up to 3 mm in depth from the surface in the first 1 hour after PDT applied, and subsequently the counts were increased in the deeper portion. A remarkable apoptosis observed up to 6 mm in depth shows that the light in use could not penetrate more than 6 mm of tissue. Tissue necrosis was identified in the deeper area of the tumor 6 hours later or thereafter. This necrosis seemed to occur as an indirect effect of vascular obstruction resulting from the damage of endothelial cells which was induced by selective collection of photosensitizer in the endothelial cells of newly forming vessels as well as in the cancer cells. These results indicate that the effective depth of PDT is greater than the depth of light penetration.
Adenocarcinoma* ; Allografts* ; Animals ; Apoptosis ; Endothelial Cells ; Mice* ; Necrosis ; Photochemotherapy*