The purpose of this study was to understand life experience of mother's abscence to the adolescent boys. Nine participants(7th-9th grades) were selected and interviewed intensively. Data were analyzed according to the methods of Colaizzi. Significant statements were extracted from data. From those significant statements, 37 themes, 15 clusters of themes and 5 categories were emerged. Fifteen cluster of themes formed 5 categories : Feeling loneliness, longing for mother and suppressing the painful feelings, sense of distance between toward father and friend, being pessimistic about the situation they face, and feeling envy. In this study the author described unique life experience of adolescent boys who are living with single father.
Adolescent* ; Fathers* ; Friends ; Humans ; Life Change Events* ; Loneliness ; Mothers ; Child Health

OBJECTIVES: Colorectal cancer is one of the major cancers in South Korea. We described the time trends in colorectal cancer incidence in Daejeon, a metropolitan city, and Chungcheongnam-do (Chungnam), a rural province, South Korea. METHODS: Using the databases from the Daejeon Cancer Registry (DCR) and the Chungnam Cancer Registry (CCR), age-standardized (to world standard population) rates for incidence (ASRW) were calculated. Average annual percent change (AAPC) was assessed as a trend indicator. The completeness (such as the mortality/incidence ratio) and validity (such as the death certificate only %, microscopic verification %, primary site uncertain %, and age unknown %) were analyzed to examine the data quality of DCR and CCR. RESULTS: Incidence of colorectal cancer showed increasing trend in both sexes. Over the years 2000-2012 in Daejeon, ASRW was increased significantly from 37.2 to 51.7 per 100,000 person-years (AAPC, 3.9%) among men and from 17.1 to 28.4 (AAPC, 3.9%) among women, respectively. In Chungnam, ASRW was also increased from 29.8 to 50.1 per 100,000 person-years (AAPC, 5.1%) among men and from 15.9 to 26.6 (AAPC, 3.2%) among women, respectively. The AAPC for colon cancer was greater than rectal cancer in both Daejeon and Chungnam. The trend of rectal cancer incidence was differ by sex (AAPC in men vs women, 2.7% vs 1.7% in Daejeon; 3.5% vs 0.8% in Chungnam). Indices of completeness and validity showed that the quality control of DCR and CCR was adequate to describe the trends of ASRW. CONCLUSIONS: Both Daejeon and Chungnam have had a rapid increase in colorectal cancer incidence. Monitoring and intervention are required on the risk factors which may contribute to this trend.
Chungcheongnam-do* ; Colonic Neoplasms ; Colorectal Neoplasms* ; Data Accuracy ; Death Certificates ; Epidemiology ; Female ; Humans ; Incidence* ; Korea* ; Male ; Quality Control ; Rectal Neoplasms ; Registries ; Risk Factors

Leiomyoma and adenomyosis of the uterus are the most common gynecologic disorders in an enlarged uterus. The characteristic US and MR findings in differentiation between both lesions were prospectively evaluated in 30 patients. Of 30 patients, 15 were leiomyomas, 6 were adenomyosises, 8 were leiomyomas and adenomyosises, and 1 was a normal pregnancy, histologically. The total number of leiomyom nodules were 49 while adenomyosises were 14 (9 diffuse and 5 focal). Among 49 myomas nodules, 36 were correctly diagnosed by sonography. The characteristic US findings of uterine leiomyoma were well defined nodules (36), hypoechoic peripheral rim (16), and whorl-like internal echoes (13). Forty four of the 49 myoma nodules were correctly diagnosed by MRI. The characteristic MR findings of myoma were well defined nodules (43), peripheral low signal intensity rim on T1WI (13) and T2WI (9), and peripheral high signal intensity rim on T2WI (5). Among 14 adenomyosises, 9 were correctly diagnosed by sonography. The characteristic US findings of adenomyosis were diffuse uterine hypertrophy more than 5.5cm in AP diameter with endometrial displacement and no significant echo change in myometrium All 14 adenomyosis as were correctly diagnosed from MRI. On T2WI, adenomyosis appeared as ill defined localized or diffuse thickening of the junctional zone more than 1cm in thickness. It was our conclusion that to differentiate between leiomyoma and adenomyosis focused on should be the detection of existence of nodule in leiomyoma, the primary sign, not on the secondary indirect sign.
Adenomyosis* ; Animals ; Female ; Humans ; Hypertrophy ; Leiomyoma* ; Magnetic Resonance Imaging ; Mice ; Myoma ; Myometrium ; Pregnancy ; Prospective Studies ; Uterus

BACKGROUND AND OBJECTIVES: Septoplasty with turbinoplasty has the potential to affect voice because it alters the vocal tract. We conducted a study to evaluate the postoperative voice changes and aid using subjective and objective data regarding the effect of surgery. SUBJECTS AND METHOD: To rule out gender bias, only 23 male patients were enrolled. Voice change was analyzed by a subjective test through a questionnaire and an objective test through acoustic analysis. During each recording session, the subject uttered the words [^m ma: the Korean word for "mother"] and [Nu Na: the Korean word for "sister"]. We then analyzed the nasal consonant ([m] in [^m ma]), the nasalized vowel ([a] in [^m ma] and [a] in [Nu Na]), and the intensity of nasal sound. RESULTS: In the subjective study, 73.9% of patients reported an improvement in the quality of voice after surgery. Most of the patients reported a reduction in twang. In the objective study, there was a tendency for increased formant frequencies in the nasal consonant, and F1 of [m] in [^m ma] was increased significantly (p=0.003). There was also a tendency for decreased formant frequencies in the nasalized vowel, F2 of [a] in [^m ma] and F1 of [a] in [Nu Na] were decreased significantly (p<0.001), and there was an increase in the intensity of nasal sound, [^m ma] (p=0.009) and [Nu Na] (p=0.013). CONCLUSION: Nasal sound became clearer with reduced twang after surgery. It is important to keep the phonetic aspect in mind when patients are undergoing septoplasty with turbinoplasty.
Acoustics ; Humans ; Male ; Methods ; Nasal Cavity ; Nasal Obstruction ; Sexism ; Voice*

BACKGROUND/AIMS: Rebleeding rate after initial endoscopic hemostasis in patients with ulcer hemorrhage has been reported in 20-30%. Identification of patients who are at high risk for rebleeding would be expected to improve the outcome of endoscopic hemostasis. The purpose of this study was to evaluate risk factors for early rebleeding after initial hemostasis in the view of clinical and endoscopic characteristics. METHODS: We reviewed 99 patients who presented with bleeding peptic ulcers and were treated with endoscopic hemostasis including hypertonic saline injection, electrocautery and clipping. We compared the clinical variables (age, pulse rate, hemoglobin), endoscopic characteristics of ulcer (size, number, and location of ulcer, clots on the base, bleeding stigmata, size and color of exposed vessel) between the patients who bled early (n=22) and who didn't bleed (n=77) within 5 days. RESULTS: The statistically significant correlates with early rebleeding after hemostasis were number of comorbid illness (> or =2) (p=0.031), volume of transfusion (> or5 units) (p=0.001), size of ulcer (>1 cm) (p=0.038), multiple ulcers (p=0.020), presence of blood clots on ulcer base (p=0.012), stigmata (active bleeding and visible vessels) (p=0.010), size of exposed vessel (>1 mm) (p<0.0001). In multivariate analysis, volume of transfusion (odds ratio[OR] 14.4), size of ulcer (OR 11.7), multiple ulcers (OR 5.5) and size of exposed vessel (OR 13.2) were significant risk factors. CONCLUSIONS: The risk factors for early rebleeding after hemostasis in bleeding peptic ulcer can be predicted by clinical variables and endoscopic findings. Early identification of risk factors such as transfusion over 5 units, large-sized ulcer, multiple ulcers, bleeding stigmata and size of exposed vessel over 1 mm can predict the prognosis of peptic ulcer bleeding.
Christianity ; Electrocoagulation ; Heart Rate ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic* ; Humans ; Multivariate Analysis ; Peptic Ulcer* ; Prognosis ; Risk Factors* ; Ulcer

BACKGROUND/AIMS: Cholestatic jaundice caused by a juxtapapillary diverticulum can be treated by excision of the diverticula or endoscopic sphincterotomy(EST). The aim of this study is to evaluate the effectiveness of EST for cholestatic jaundice in patient with juxtapapillary diverticulum with absence of common bile duct stones. METHODS: We recruited patients who underwent Endoscopic Retrograde Cholangio Pancreatography(ERCP) between September 2000 and May 2005. The presence of Juxtapapillary diverticula was seen in 92(29.3%)) out of 315 patients underwent ERCP. Cholestatic jaundice associated with juxtapapillary diverticula was considered when patients have jaundice, elevated serum bilirubin and alkaline phosphatase more than normal, and there are no other obstructive lesion on abdominal ultrasonography or computed tomography(CT) scan. The number of the patients were 13 who had cholestatic jaundice associated with juxtapapillary diverticula without common bile duct stones. All 13 patients underwent EST and had no complications. The patients were followed up to visit outpatient department or interviewed on the telephone. RESULTS: Of the 13 patients, 10 were male and 3 were female. The mean age was 70.4 years and mean duration of follow-up were 28.9 months. All 13 patients who had gallbladder presented RUQ discomfort and jaundice. Seven patients presented gallstone pancreatitis with jaundice. Nine patients had GB stone, 1 patients had GB sludge. In the follow-up period, from 1month to 46 months after EST, 1 patient died of unknown cause within 1 year. One patient had recurred gall stone pancreatitis with jaundice 12 months later. CONCLUSIONS: EST can be considered as a useful therapeutic modality especially in eldery patients with cholestatic jaundice and gallstone pancreatitis associated with juxtapapillary diverticulum.
Alkaline Phosphatase ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive* ; Male ; Outpatients ; Pancreatitis ; Sewage ; Telephone ; Ultrasonography

PURPOSE: We hypothesize that the presence of barium sulfate debris plays an influential role to deteriorate the balance of bone remodelling around prosthesis via cytotoxic mechanism to osteoblast. MATERIALS AND METHODS: Osteoblasts were obtained from the neonatal rat calvarium, and SiO2, TiO2 , PMMA and BaSO4 particles were prepared for the evaluation of particle induced cytotoxicity to osteoblast. Osteoblasts were grown in DMEM and then were seeded into 6 well culture plates. 1.0wt% solution of each particle was added to culture medium to generate a final concentration of 0.1wt%, and 0.005wt% of various particles in each well, respectively. The measurement of intracellular calcium was conducted using various agonists of calcium. The cell viability assay for osteoblast was performed with MTT reduction assay and the mineralization of the matrix was checked by Von Kossa staining. ELISA kit was used to quantify the level of osteocalcin in osteoblast. RESULTS: BaSO4 significantly lowered the cell viability. All particles except TiO2 increased [Ca(2+)]i transiently, and the rank of differential cytosolic [Ca(2+)]i was in order as follows; SiO2, BaSO4, and PMMA. The mineralization was significantly prohibited in SiO2 and BaSO4(0.1wt%), however the PMMA showed no definite inhibitory effect on bone mineralization. PMMA(0.1wt%) and BaSO4(0.1wt%) showed significantly inhibitory effect on osteocalcin production. CONCOUSION: In higher concentration, BaSO4 has a cytotoxic effect on osteoblast and inhibitory effect of osteocalcin production as well as mineralization of osteoblast. Also, this study has shown that the concentration of intracellular calcium is strongly influenced by exposure to BaSO4 particles in vitro. The effect of BaSO4 on osteoblast observed in this study could have implications for the role of BaSO4 particles on osteoblast function at aseptic loosening of cemented total joint arthroplasty.
Animals ; Arthroplasty ; Barium Sulfate ; Calcification, Physiologic ; Calcium ; Cell Survival ; Cytosol ; Enzyme-Linked Immunosorbent Assay ; Joints ; Osteoblasts* ; Osteocalcin ; Polymethyl Methacrylate ; Prostheses and Implants ; Rats* ; Skull

BACKGROUND: Adequate depth of anesthesia requires a sufficient amount of the agent to secure unconsciousness and other components of anesthesia as needed for that particular surgical procedure, without jeopardizing vital organ functions. To evaluate the relationship of depth of anesthesia to EEG, we studied the effects of increasing minimum alveolar concentration (MAC) of isoflurane (arousal, 1, 1.3, 1.5 MAC) on power spectral analysis of the EEG. METHODS: To determine 1 MAC, we studied sixty patients undergoing general anesthesia who were randomly allocated to receive isoflurane at several predetermined end-tidal concentration. A minimum of 15 min was allowed between induction and skin incision to allow steady state condition. Patients were observed for gross purposeful movement for 60 seconds after incision. The MAC was calculated using maximum likelihood solution to a logistic regression model. Another forty patients were randomly allocated to have their EEGs recorded. General anesthesia was induced with oxygen and isoflurane only. After loss of consciousness, succinylcholine 1.5 mg/kg was given and intubation followed. The EEG was recorded awake and after 15 min at steady state conditions of 1, 1.3 and 1.5 MAC isoflurane had been achieved. Spectral edge frequency 95% (SEF95), median spectral frequency (MSF), total power (TP) and relative power in the delta, theta, alpha and beta band were calculated. RESULTS: The MAC of isoflurane was 1.21 vol% (20 - 40 years) and 1.09 vol% (40 - 60 years). The distribution of spectral EEG indices of the EEGs were established and compared. The threshold value of SEF95 14 Hz to differentiate between arousal and 1.3 and 1.5 MAC had a sensitivity of 60.5% (1.3 MAC), 71% (1.5 MAC) and specificity of 74.4% (1.3 and 1.5 MAC) and that of MSF 5 Hz had a sensitivity of 71% (1.3 MAC), 81.5% (1.5 MAC) and specificity of 48% (1.3 MAC), 48.8% (1.5 MAC). CONCLUSIONS: With regard to the dose-related decrease in SEF95 and MSF under increasing end- expiratory concentrations of isoflurane as described in the present study, future studies may have todetermine whether EEG feedback control of volatile anesthetic administration may be used successfully. It seems that if neglected parts by MSF and SEF95, which are really true values are considered in the future studies, those would increase the sensitivity and specificity of EEG could be used as tool for determining depth of anesthesia.
Anesthesia ; Anesthesia, General ; Arousal ; Electroencephalography* ; Humans ; Intubation ; Isoflurane* ; Logistic Models ; Neurofeedback ; Oxygen ; Sensitivity and Specificity ; Skin ; Succinylcholine ; Unconsciousness

OBJECTIVES: Since Korea has been known to be one of the endemic area for hepatitis B virus(HBV) infection, vaccination for HBV has been recommended for all neonates in Korea. After starting vaccination in 1983, the change of sero-positivity of HBsAg and HBsAb is expected. This study was carried out to investigate the seropositive rate of hepatitis B virus surface antigen and antibody in high school freshmen students in Chungju-city. METHODS AND MATERIALS: From 1998 to 2001, a total of 11,735 who were born in 1982 to 1986, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. PESULTS: The study population was 11,735 students who were composed of 5,813 males (49.6%) and 5,914 females (50.4%). The HBsAg sero-positivity of male and female students was 3.25% (n=381) and 2.59% (n=153) respectively. The anti-HBs sero-positivity of male and female students was 62.2% (n=3,154) and 64.1% (n=2,969) respectively. There are significant difference observed in comparison of HBsAg and anti-HBs seropositivity according to sex (p<0.05). From 1982 to 1986 on birth year, anti-HBs sero-positivity has been increased significantly from 63.3% to 73.3%. But the change of HBsAg sero-positivity has not been changed significantly. CONCLUSIONS: As compared with previous studies of HBsAg and anti-HBs, the sero-positive rate of HBsAg has not been changed but that of HBsAb has been increased significantly. This result revealed that the effect of HBV vaccination program was successful.
Antigens, Surface ; Female ; Hemagglutination ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Infant, Newborn ; Korea ; Male ; Parturition ; Vaccination

Objectives: This study examined the results of the restandardization of the Korean Personality Assessment Inventory (PAI). The Korean PAI was first standardized in 2001 and then restandardized in 2019 to establish new normative data. On the other hand, differences may exist in the results of the restandardized version considering the time interval, which may include cultural and social differences. Thus, differences between the results of the Korean PAI administered in 2001 and 2019 must be examined to confirm its new normative data followed by restandardization. Methods: Data from 2212 adults who administered the original Korean PAI in 2001 and 1263 adults who administered the Korean PAI in 2019 were collected. The study compared the reliability and mean scores. In addition, the mean scores of the Korean PAI administered in 2019 were converted to T-scores adapted to the normative data of 2001. The collected data was analyzed using a t-test and comparing the T-scores. Results: The internal consistency reliability showed a similar pattern in both versions, but the differences among the mean scores and T-scores appeared to be significant. Conclusion The significant differences between the scores of the Korean PAI administered in 2001 and 2019 reflect the result of the restandardization. Therefore, the restandardized version of the Korean PAI may bring more precise information that can be adapted to the contemporary era.