BACKGROUND: This study was done to identify factors that influence the willingness to be vaccinated with the human papilloma virus (HPV) vaccine in female college students eligible for a catch-up vaccination program. METHODS: This cross-sectional study included 572 female students aged 18-26 years attending one selected university in the Gyeongbuk Province. From March 2 to 6, 2009, they completed a self-administered questionnaire on their HPV vaccination status. Thereafter, unvaccinated participants were educated about the vaccination program, and each participant's willingness to be vaccinated was assessed. RESULTS: Of the 572 participants, 18 (3.1%) were already vaccinated with the HPV vaccine. The number of participants advised to be vaccinated was 102 (17.8%). Of the 554 unvaccinated participants, 305 (55.1%) were willing to be vaccinated after being educated about the vaccination program. Of the remaining 249 unvaccinated participants, 116 (48.7%) refused the vaccine due to its high cost. Advice by family members was related significantly to the willingness to be vaccinated (odds ratio, 2.37; 95% confidence interval, 1.09-5.14). CONCLUSIONS: The results of this study suggest that the willingness to be vaccinated with the HPV vaccine could be increased in female college students if they are advised to do so by their family members after being educated about the vaccination program.
Aged ; Cross-Sectional Studies ; Female ; Humans ; Papilloma ; Vaccination ; Viruses ; Surveys and Questionnaires

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

From July 1997, Authors have reconstructed the posterior cruciate ligament(PCL) deficient knees with two graft tendons; an autogenous bone-patellar tendon-bone (BPTB) and a semitendinosus tendon. At Femoral side, the two graft tendons were fixed through the two tunnels which were made at the site of foot print of PCL. The original site of anterolateral bundle of the PCL was reconstructe(I with the autogenous BPTB and the original site of posteromedial bundle with the semitendinosus tendon. At tibial side, the two graft tendons were fixed by modified inlay technique; the BPTB was fixed with a cancellous screw and the semitendinosus tendon with staples. Seven cases were followed up more than six months and authors evaluated the results with the KT-1000TM arthrometer and the posterior stress radiographs by Telos stress dcvice and compared the resu]t of injured knee with the uninjured side of each patient. The results of manual maximal displacement test with arthrometer were less than 4 mm in six patients and 8 rnm in one patient at last follow up. The average distance of posterior displacement on stress radiographs was 10.3 mm preoperatively and 2.7 mm at final follow up period. Six of the seven patients had a good stability on posterior stress radiographs compared with the uninjured side. One patient had posterior knee insta- bility on stress radiographs due to loosening of the grafted tendon and retightening of the grafted tendon was performed through the posterior approach to the proximal tibia. The original idea of femoral dual tunnel method in PCL reconstructiori is to reconstruct the PCL more anatomically and the modified tibial inlay technique can solve the problern of graft tendon abrasion at the posterior opening of the tibial tunnel in transtibial tunnel method and retightening of the loose grafted tendon is simple than the other methods of PCL reconstruction. Authors expect that this combined femoral dual tun- nel and modified tibial inlay method may improve the quality of the outcome of the arthroscopic PCL reconstruction.
Arthroscopy ; Follow-Up Studies ; Foot ; Humans ; Inlays* ; Knee ; Posterior Cruciate Ligament* ; Tendons* ; Tibia ; Transplants*

The arthroscopic procedure has been one of the useful treatment modalitis in osteoarthritis of the knee, which does not respond to conservative treatment. Authors reviewed the resuJts of 61cases of 61 patients(18 males and 43 females) that had been treated with arthroscopic procedures including arthroscopic simple )avage, partial menisectomy, removal of the loose bodies, synovectomy and chondroplasty. The purpose of this study is to evaluate indication and effectiveness of arthroscopic surgery for osteoarthritic knee. 1. Seventy-one percent of sixty-one patients had relief of pain and other clinical symptoms after arthroscopic procedures. 2. Sixty-one pereent were still good at last follow-up more, than one year. 3. The favorable results were obtained after removal of loose bodies or partial menisectomy in association with osteoarthritic knee cornpared with the other procedures. And the poor results were obtained in patients with severe degenerative changes and severe cartilage defects of both femoral condyles. 4. The normal-alignment knees had much better results after arthroscopic surgery compared with valgus or varus knees. Our results suggest that arthroscopic surgery can be one of the good alternative treatment methods for osteoarthritic knee and a time-saving procedure before arthroplastic surgery.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee* ; Male ; Osteoarthritis

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about 7.3×7.1×6.5cm in size in the upper and mid-pole of the right kidney, involving. renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.
Adult ; Biopsy ; Coloring Agents ; Dyspnea ; Endothelial Cells ; Factor VIII ; Hemangiosarcoma* ; Hematuria ; Humans ; Kidney ; Lung ; Male ; Mucus ; Neoplasm Metastasis ; Pleural Effusion* ; Pleurisy ; Pleurodesis ; Radiography ; Thorax ; Ultrasonography

The Korean Medical Association opposes the illegal attempt to implement the physician assistant (PA) system in Korea. The exact meaning of ‘PA’ in Korea at present time is ’Unlicensed Assistant (UA)’ since it is not legally established in our healthcare system. Thus, PA in Korea refers to unlawful, unqualified, auxiliary personnel for medical practitioners. There have been several issues with the illegal PA system in Korea facing medicosocial conflicts and crisis. Patients want to be diagnosed and treated by medically-educated, licensed and professionally trained physicians not PAs. In clinical settings, PAs deprive the training and educational opportunities of trainees such as interns and residents. Recently, there have been several attempts, by CEO or directors of major hospitals in Korea, to adopt and legalize this system without general consensus from medical professional associations and societies. Without such consensus, this illegal implementation of PA system will create new and additional very serious medical crises due to unlawful medical, educational, professional conflicts and safety issues in medical practice. Before considering the implementation of the PA system, there needs to be a convincing justification by solving the fundamental problems beforehand, such as the collapsed medical delivery system, protection and provision of optimal education program and training environment of trainees, burnout from excessive workloads of physicians with very low compensational system and poor conditions for working and education, etc.

The Korean Medical Association opposes the illegal attempt to implement the physician assistant (PA) system in Korea. The exact meaning of ‘PA’ in Korea at present time is ’Unlicensed Assistant (UA)’ since it is not legally established in our healthcare system. Thus, PA in Korea refers to unlawful, unqualified, auxiliary personnel for medical practitioners. There have been several issues with the illegal PA system in Korea facing medicosocial conflicts and crisis. Patients want to be diagnosed and treated by medically-educated, licensed and professionally trained physicians not PAs. In clinical settings, PAs deprive the training and educational opportunities of trainees such as interns and residents. Recently, there have been several attempts, by CEO or directors of major hospitals in Korea, to adopt and legalize this system without general consensus from medical professional associations and societies. Without such consensus, this illegal implementation of PA system will create new and additional very serious medical crises due to unlawful medical, educational, professional conflicts and safety issues in medical practice. Before considering the implementation of the PA system, there needs to be a convincing justification by solving the fundamental problems beforehand, such as the collapsed medical delivery system, protection and provision of optimal education program and training environment of trainees, burnout from excessive workloads of physicians with very low compensational system and poor conditions for working and education, etc.

OBJECTIVES: Patients with poor insight are commonly observed among schizophrenics and they show poor drug compliance and prognosis. This study aimed at examining the characteristics of psychopathology in patients with schizophrenia who have no insight. Understanding the features of inner psychopathology in schizophrenic patients with poor insight, we assumed, could lead to insight-promoting clues. METHODS: The subjects consisted of 69 patients with schizophrenia diagnosed by DSM-IV criteria. For identifying insight level in the patients, Scale to Assess Unawareness of Mental Disorder(SUMD) was applied. After subjects were divided into two groups depending upon insight level, psychopathological differences were evaluated by Kyung Hee-Frankfruter Beschwerde Fragebogen(K-FBF), which was known as one of the subjective psychological tests for the schizophrenics. RESULTS: There was no significant differences in demographic variables, duration of illness, and dose of medication between two groups. However, significantly high rate of involuntary admission and tendency of high frequency of admission were revealed in schizophrenic patients with poor insight. And, also poor insight group showed significantly high scores in the factors of sensorimotor disorder(subscales of psychomotor disorder, perceptual disorder and blocking symptoms included) and in language-cognitive disorder factor(subscales of language disorder and cognitive floating included) compared with patients who have insight. CONCLUSION: We was assumed that lack of insight in schizophrenics could include one of the symptoms based on neuropsychological or neurobiological abnormalities in brain. Moreover, it was revealed that patients with poor insight evaluated themselves as having more serious psychopathologies than patients who had insight. It has been already known that schizophrenic patients who lack in insight are reluctant to taking psychiatric care and lack in awareness of their illness. However, this study suggests that their inner psychopathology associated with insight can be understood with the use of subjective psychological test, i.e. K-FBF. For understanding the schizophrenic patients who lack in insight, not only checking the insight but also applying the subjective test such as K-FBF seems to be helpful.
Brain ; Compliance ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Language Disorders ; Perceptual Disorders ; Prognosis ; Psychological Tests ; Psychopathology* ; Schizophrenia

PURPOSE: The clusterin expression has been associated with tumorigenesis of various malignancies, including tumors of the prostate, colon and breast. Furthermore, the expression of clusterin is modulated by many factors that are believed to regulate tumor growth and apoptosis. We studied the clusterin expression in transitional cell carcinoma (TCC) of the bladder and we investigated its correlation with apoptosis. MATERIALS AND METHODS: Eighty five bladder tumor specimens from radical cystectomy or transurethral resection were subjected to immunohistochemical clusterin staining with Ig G clusterin Ab. We examined the immunohistochemical localization of clusterin, and this was followed by TUNEL staining to detect the apoptotic cells. After double-staining with Hoechst 33258, we detected the apoptotic cells under a fluorescence microscope and we calculated the apoptotic index. RESULTS: Invasive TCC showed a stronger positive expression of clusterin as compared with superficial TCC, but the positivity of the clusterin expression was not in proportion to the tumor grade. The apoptotic indices of cancer were 0.52+/-0.28%, 0.30+/-0.16% and 0.17+/-0.11% in Grade I, Grade II and Grade III superficial TCC, respectively, and it was 0.23+/-0.13% in Grade III invasive TCC. Apoptotic cells were not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis. CONCLUSIONS: These results suggest that clusterin could be used as a marker to provide prognostic information for the TCC patients. The apoptotic index revealed that apoptosis and the clusterin expression have correlation with transitional cell cancer. Further study will be needed to clarify the role of clusterin as a therapeutic target for cancer treatment.
Apoptosis* ; Bisbenzimidazole ; Breast ; Carcinogenesis ; Carcinoma, Transitional Cell* ; Clusterin* ; Colon ; Cystectomy ; Fluorescence ; Humans ; In Situ Nick-End Labeling ; Prostate ; Urinary Bladder Neoplasms ; Urinary Bladder*

Syngnathia(maxillomandidular fusion) is a rare congenital anomaly involving soft tissue bony adhesions between the maxilla and mandible. Bony fusion, as in this case, is extremely rare and to the time, no specific anesthetic management has been reported. In our case, physical examinition of the 130-day infant patient(weight 5.5kg) with syngnathia revealed apparent left side fusion between maxilla and mandible. The opening between upper and lower gingiva was limited to 10mm on the right side. Left choanal atresia, microstomia, low set ears and blue sclera were also detected. When patient arrived at the OR.5l/min oxygen was administered using nasal prong with end-tidal CO2 monnitoring cannula though mough. Glycopyrrolate 0.1mg and ketamine 5mg were administered intravenously. A solution of 2% lidocaine 2ml and 0.1% phenylephrine 1ml was used to topicalize the right nostril. Subanesthetic doses(2~3mg) of ketamine were used to provide sedation while maintaining spontaneous ventilation. Warm, softed I.D. 3.5mm preformed nasotracheal tube was inserted via the rigrht nostril with a 3.2mm O.D. fiberoptic bronchoscope. After that vecuronium and dexamethasone were given intravenously. The Infant had been anesthetized uneventfully with isoflurane. Fiberoptic nasotracheal intubation under spontaneous ventilation using low doses of ketamine offers a safe and non-invasive technique compared with tracheostomy or blind nasotracheal intubtion. To increase safey, oxygen should be given via nasal or oral routes and adequate monitoring, especially capnography and pulse oxymeter, should be performed.
Airway Management* ; Bronchoscopes ; Capnography ; Catheters ; Choanal Atresia ; Dexamethasone ; Ear ; Gingiva ; Glycopyrrolate ; Humans ; Infant ; Intubation ; Isoflurane ; Ketamine ; Lidocaine ; Mandible ; Maxilla ; Microstomia ; Oxygen ; Phenylephrine ; Sclera ; Tracheostomy ; Vecuronium Bromide ; Ventilation