With rapid industrialization and urbanization, environmental pollution has become an urgent health problem. Asthma attack is a common and severe disease, and can be a sentinel event of worsening air pollution. There are, however, few studies about the epidemiolgy of asthma and the association between asthma and low level air pollution in Korea. This study was conducted to describe the trend and pattern of asthma attack and to examine the effect of air pollutants on admission in Korea. Combined data of this study are medical insurance claims for asthma, data from telemetry system of the Ministry of Environment for air pollutants, and air temperatures from monthly weather reports of the Meteorological Administration. To describe the temporal trends of asthma in Korea, insurance claims since 1985 were analized. Age specific asthma visit/admissions per 1000 eligible persons, as well as ratio of asthma visit/admissions over all visit/admissions showed a steady increase in asthma attack in Korea. Asthma prevalence was relatively high among under 5 years and over 50 years of age, and in these age groups asthma was more prevalent among males. The effects of relatively low level air pollution and weather condition on the number of patients who had asthma attacks admitted to hospitals in Seoul area were studied from April 2 to April 24, 1993. Asthma admissions were examined throughout the study period (392 cases), except sunday and holiday(354 cases) and except sunday, holiday and saturday (293 cases), while grouped into three age categories (3 12, over 40, and all age). Following results were obtained through correlation and multiple regression analysis. The number of adimission were significantly correlated with ambient air concentrations of total suspended particles (TSP), sulfur dioxide (SO2) and carbon monoxide(CO). 1) The number of admissions on the same day were significantly correlated with ambient air maximal concentrations of total suspended particcles among persons who were above 40 year old. 2) The effects of maximal daily concentrations of sulfer dioxide(SO2) among persons who were of 3- 12 age were significant when one day lagged asthma admission was compared with the air pollution on the previous day. 3) The number of admissions on 1-day lag were significantly correlated with ambient air maximal daily concentrations of carbon monoxide(CO) among persons who were above 40 year old. The associations between temperatures and number of admissions were not significant in this study. Levels of pollutants were fairly low, the monthly mean being 0.022 ppm for SO2, 0.032 ppm for NO2, 3.2 ppm for CO, 0.015 ppm for 03, and 240 micro gram/m3 for TSP. The mean temperature was 10.6degrees C. These results suggest that concentration of air pollutants lower than those given as guidelines may increase the incidence of asthma attacks.
Adult ; Air Pollutants ; Air Pollution* ; Asthma* ; Carbon ; Environmental Pollution ; Holidays ; Humans ; Incidence ; Insurance ; Korea* ; Male ; Prevalence ; Seoul ; Sulfur Dioxide ; Telemetry ; Urbanization ; Weather

We have experienced 19 patients of the cerebral arteriovenous malformation with subarachnoid hemorrhage, who were admitted to the Presbyterian Hospital, Daegu from January 1966 to July 1968, and to the Catholic Medical Center, Seoul from August 1968 to August 1971. All of the patients, who have the cerebral arteriovenous malformation, were proved by cerebral angiography. Since the site of lesions were considered to have close relation to the neurologic deficit and the result of surgery, various analysis of the clinical manifestations and the cerebral angiographic findings were attempted. Of the 19 patients, surgery was performed on 12 patients and its results were analyzed correlating to various types of surgical procedure. Following are the results. 1. From January 1966 to August 1971, there were 100 cases of cerebral vascular anomalies which were proved by cerebral angiography. Among the 100 cases, there were 71 intracranial aneurysms, 19 cerebral arteriovenous malformations, one cavernous angioma, 2 telangiectasis, 5 cerebral rete mirabile, and s Sturge Weber-Dimitris disease. The ratio of arteriovenous malformatons to aneurysms was 1: 3.7. 2. Age distribution of the bleeding arteriovenous malformations was ranged from 8 to 54, and 42 per cent of them were in the third decade. 73 percent of the group had bleeding from the cerebral arteriovenous malformation before the age of 40. The ratio of male to female was 1.9:1. 3. The parietal region was most commonly involved by the malformations. There were 8 parietal lesion, 4 temoroparietal lesions, one temporal lesion, one occipital lesion, and one tela chorioidea lesion. Simultaneous involvement of the both hemispheres occurred in one case. In lesions involving the cerebral hemisphere, there was a predominance of the left side. 4. In the past history, convulsive seizure was recorded in two cases and recurrent hemorrhages were reported in two. One patient was recorded to have suffered fourth hemorrhage and the other have sufferd third hemorrhge. 5. Meningeal irritation signs were most frequently observed in bleeding arteriovenous malformations. The incidence of weakness of extremities was higher in lesions involving the parietal area. Unconsciousness was occurred in 6 patients at the onset of symptom, of which transient loss of consciousness was seen in 3 patients. Transient hypertension at the onset was observed in two patients. 6. The feeding arteries of the malformations were most frequently seen from the middle cerebral artery and the draining veins from the malformations were into the superior sagittal sinus and internal cerebral vein in many cases. It was evident that the carotid artery of the sites of arteriovenous malformations was markedly dilated in 5 patients. 7. Ligation of the vessels feeding the arteriovenous malformations was carried out in 8 patients. One patient had neurologic deficit after the operation. Evacuation of intracerebral hematoma, resection of the anomaly or carotid ligation were carried out in 4 patients. Of the 12 patients who underwent various types of surgery, there was one death after evacuation of a large intracereral hematoma. 8. In our opinion, the ligation of feeding artery a choice of procedure to reduce the incidence of rebleeding, if the resection of the lesion was considered to have operative risk by the location of malformations.
Age Distribution ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Carotid Arteries ; Cerebral Angiography ; Cerebral Veins ; Cerebrum ; Daegu ; Extremities ; Female ; Hemangioma, Cavernous ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Intracranial Aneurysm ; Intracranial Arteriovenous Malformations ; Ligation ; Male ; Middle Cerebral Artery ; Neurologic Manifestations ; Protestantism ; Rabeprazole ; Seizures ; Seoul ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus ; Telangiectasis ; Unconsciousness ; Veins

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

Purpose: The aim of this retrospective study was to define the prognostic factors for liposarcoma to aid in the selection of effectivetreatments. Materials and Methods: This study analyzed 41 cases out of 45 cases diagnosed with and treated for liposarcoma 2002 to 2015; 4 casesof well-differentiated liposarcoma were excluded. The effects of sex, age, site, stage, and histological classification on survival wereanalyzed retrospectively. For 28 cases diagnosed with myxoid liposarcoma, additional analysis was performed after the inclusion of roundcell components. Results: The mean age at diagnosis was 52.05 years (range 25–82 years) and the average follow-up period was 63.7 months. The diseasefreesurvival rate was 43.2%. Most factors, including sex and age, were not significantly associated with the survival rate. On the otherhand, the stage (Musculoskeletal Tumor Society stage) was significantly associated with the survival rate. The survival rate of patients withmyxoid liposarcoma was 69% and the local recurrence and metastasis results varied according to the presence of round cells. Conclusion The stage of liposarcoma and the sex of the patient were found to be effective factors for prognosis. When planning thetreatment for liposarcoma, the treatment outcome for liposarcoma differs according to several prognostic factors.

BACKGROUND: Because up to 80% of all illness encountered in a primary care physician's office is due to psychological stress, stress management is important for the aged who are susceptible to stress. The positive effect of exercise therapy on psychological stress has been studied for a long time, but the research related to geriatric stress and exercise is still insufficient. Therefore, we investigated the effect of aquarobics, which is known to be suitable for the aged, on the stress reduction. METHODS: The data were collected from 11 women over 60 years old who visited the Public Health Center of Seodaemun-gu Office. The subjects participated in a 3 months' water exercise program 2 times a week for 60 minutes. Before and after exercise program, they were assessed according to Modified-Korean BEPSI scores. RESULTS: The subjects exercised 31 times on average (Maximum 40). Before exercise, mean BEPSI score was 1.6, which conformed to moderate risk group, but after 3 months exercise program they showed statistically significant stress reduction when compared to pre-exercise state (P=0.0313). CONCLUSION: We conclude that 3 months water exercise program reduced stress effectively in the aged over 60 years.
Exercise Therapy ; Female ; Geriatrics ; Humans ; Middle Aged ; Physicians' Offices ; Primary Health Care ; Public Health ; Stress, Psychological ; Water*

Corticosteroids are considered to be one of the most effective medicine for asthma by suppressing airway inflammation. This study was carried out to investigate the effects of prednisolone in the sputum of exacerbated asthmatics. Clinical severity, cell differentials, levels of interleukin (IL)-5, eosinophil cationic protein (ECP), EG2+ eosinophils, and nitric oxide (NO) metabolites were measured. Sputum was examined 2 weeks apart in 13 exacerbated asthmatics before and after prednisolone treatment, and once in 12 stable asthmatics. We used a sandwich ELISA for IL-5, fluoroimmunoassay for ECP, immunohistochemical staining for EG2+ eosinophils, a NO metabolites assay using modified Griess reaction. Exacerbated asthmatics, in comparison with stable asthmatics, had significantly higher proportion of eosinophils, higher level of ECP, higher percentage of EG2+ eosinophils, and NO metabolites. Exacerbated asthmatics after treatment with prednisolone had reduced the proportions of eosinophils, reduced level of IL-5, ECP and percentage of EG2+ eosinophils. FEV1 was correlated with the proportion of eosinophils, ECP, and IL-5 respectively. These findings suggest that prednisolone is considered to be effective medicine for asthma by suppressing eosinophil activation through IL-5.
Administration, Oral ; Adolescence ; Adrenal Cortex/metabolism ; Adult ; Aged ; Anti-Inflammatory Agents, Steroidal/administration & dosage* ; Asthma/metabolism ; Asthma/immunology* ; Asthma/drug therapy* ; Biological Markers ; Blood Proteins/metabolism* ; Eosinophils/metabolism ; Eosinophils/immunology ; Eosinophils/drug effects* ; Female ; Human ; Interleukin-5/metabolism* ; Leukocyte Count ; Male ; Middle Age ; Nitric Oxide/metabolism ; Prednisolone/administration & dosage* ; Sputum/immunology ; Sputum/cytology

BACKGROUND: The herbicides used in Vietnam were later found to be extremely contaminated with 2,3,7, 8-tetrachlorodibenzo-rho-dioxin (TCDD). The carcinogenecity of the product was for all cancers combined. The risk of soft tissue sarcoma, lung cancer, and lymphoma, chloracne, peripheral neuropathy and other diseases were found to be increased. Although many veterans exposed to herbicides had chronic skin diseases with variable clinical features, there were few researches about herbicides-related skin diseases. The purpose of this study was to investigate the characteristics of herbicides-related skin diseases and to provide epidemiologic information. METHODS: This study has been reviewed in the clinical findings of 127 veterans with skin diseases exposed to herbicides who visited Kosin University Gospel Hospital during the 5 years from January of 1997 to December of 2001. RESULTS: The age distribution was in the range of 47~68 years. The mean age was 54.6 years old. All patients were male. In the duration, 34 patients (26.8%) developed skin diseases for 6~10 years, 21 patients (16.5%) for 16~20 years, and 21 patients (16.5%), 25 years. In the incidence, seborrheic dermatitis was the most frequently observed in 45 patients (35.4%) followed by eczematous dermatitis in 41 patients (32.3%), xerotic eczema in 23 (18.1%) and pruritic dermatoses in 21 (16.5 %). In the incidence ratio of skin diseases with systemic diseases, chronic urticaria was the most highly observed with 100% (1/1) followed by fungal infection in 70% (7/10), other diseases in 66.6% (6/9), seborrheic dermatitis in 64.4% (29/45), eczematous dermatitis in 56.1% (23/41), and xerotic eczema in 52.2% (12/23). Sixty eight patients had skin diseases with systemic disease. Hypertension and diabetes were most frequently observed with 24 and 23 patients, respectively. The order of incidence was as follows: liver disease, gastroduodenal ulcer, peripheral neuropathy, chronic gastroenteritis, and hyperlipidemia. Mycosis fungoides was found in 4 cases and monoclonal T cell gamma receptor gene rear-rangement was detected in 2 cases (50%). CONCLUSION: Skin diseases among veterans exposed to herbicides used in Vietnam was chronic and showed variable clinical features. It was difficult to confirm the relationship between skin diseases and herbicides, but further researches are required to seek guidelines for the evaluation of skin diseases.
Age Distribution ; Chloracne ; Chronic Disease ; Dermatitis, Seborrheic ; Eczema ; Gastroenteritis ; Herbicides* ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Liver Diseases ; Lung Neoplasms ; Lymphoma ; Male ; Mycosis Fungoides ; Peptic Ulcer ; Peripheral Nervous System Diseases ; Sarcoma ; Skin Diseases* ; Skin* ; Urticaria ; Veterans* ; Vietnam*

Authors have experienced 104 cases of the intracranial aneurysms with subarachnoid hemorrhage, who were proved to have aneurysms by cerebral angiography for past 8 years. Aneurysms surgery under controlled hypotension has shown far better result than that of surgery under hypothermia, carotid ligation or conservative treatment. Of the 104 cases, the site distribution of aneurysms and the result of various treatment are analyzed. Followings are the results. 1. Anterior communication aneurysm was 44 per cent of the cases and it was most common site of the intracranial aneurysms. 19 per cent of aneurysms located on internal carotid artery at the posterior communicating artery, and middle cerebral artery aneurysm was 16%. The site distribution of aneurysms in Korean has shown marked difference from the reports of other countries. 2. Of 40 cases, who received conservative therapy, 15 cases (375% ) were expired, and most of them were dead due to rebleeding from aneurysms. 3. The direct attack of aneurysms through intracranial approach was performed under moderate hypothermia till 1970, and controlled hypotension was introduced thereafter. In 19 cases of intracranial aneurysm surgery, 7(14.2%) were expired following surgery. 4. Mortality of the carotid ligation for 15 cases of the intracranial aneurysms was 40 per cent. Cerebral ischemia or rebleeding was cause of death. 5. Intracranial aneurysm surgery under hypotension was carried out in 16 cases, and one cases (6.2%) was expired. Induced hypotension and careful identification of aneurysm and neighbouring structures by magnify operating glasses promoted operative result in aneurysm surgery.
Aneurysm* ; Arteries ; Brain Ischemia ; Carotid Artery, Internal ; Cause of Death ; Cerebral Angiography ; Eyeglasses ; Glass ; Hypotension* ; Hypotension, Controlled ; Hypothermia ; Intracranial Aneurysm* ; Ligation ; Mortality ; Subarachnoid Hemorrhage

BACKGROUND: Enteroviruses are the most frequent etiologic agents of aseptic meningitis and are estimated to be the cause of 70% to 90% of viral meningitis cases. Enterovirus diagnosis can be difficult because clinical features vary according to patient immunity and age. The purpose of this study was to evaluate the performance of the real-time nucleic acid sequence-based amplification (NASBA) assay compared to that of the real-time nested RT-PCR assay for enterovirus detection. METHODS: This study was performed on 96 patients suspected of aseptic meningitis based on clinical features. RNA was extracted using NucliSENS EasyMAG and real-time NASBA assay was performed using NucliSENS EasyQ Enterovirus and NucliSENS EasyQ Basic 2. We also executed in-house real-time nested RT-PCR assay for RNA extracted via QIAamp Viral RNA Mini. RESULTS: The positive rate of real-time NASBA assay was 45.8% for enterovirus detection. The positive rate of first real-time reverse transcription PCR was 22.9% and the second real-time PCR was 57.3%. The concordant rate of the real-time NASBA assay and first real-time reverse transcription PCR was 75.0%. The concordant rate of the real-time NASBA assay and second real-time PCR was 86.5%. CONCLUSION: The detection of enteroviruses using the real-time NASBA assay is less prone to cross-contamination and is simple, without the need for reverse transcription. We conclude that the NASBA assay is an effective method for the rapid diagnosis of aseptic meningitis.
Enterovirus ; Humans ; Meningitis, Aseptic ; Meningitis, Viral ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; RNA ; RNA, Viral ; Self-Sustained Sequence Replication

PURPOSE: The diagnosis of clinically early-stage (T1) renal cell carcinoma (RCC) has increased. The present study evaluated the association of B7-H4 expression on the pathological outcome and recurrence of carcinoma in the T1 stage of RCC. MATERIALS AND METHODS: Among patients who underwent partial or radical nephrectomy after diagnosis of T1 stage RCC during the period of January 2000 to March 2007, 102 pathologically confirmed cases of clear cell carcinoma were included in this study. The patients' medical records were reviewed retrospectively. For the immunohistochemical staining tests, the B7-H4 antibody (Abbiotec 1:500) was used, and clinicopathological characteristics were analyzed. RESULTS: The mean age of the patients (39 males: 38.2%, 63 females: 61.8%) was 53.0+/-12.0 years (range, 31-74 years), and the mean follow-up time was 33.4+/-21.0 months (range, 6-84 months). B7-H4 expression was positive in 18 cases and negative in 84 cases. Recurrence during the follow-up period occurred in 5 cases in the group with positive B7-H4 expression and in 7 cases in the group with negative B7-H4 expression, respectively (p=0.035). In the univariate analysis, a statistically significant relationship was observed only for the presence of B7-H4 expression (p=0.0019). In the multivariate analysis, other than the expression of B7-H4, cancer size and TNM stage had effects on the recurrence of cancer. CONCLUSIONS: For clear cell RCC, B7-H4 expression had a critical impact on the prognosis of the patients, particularly on the recurrence of the carcinoma in patients with clinical stage T1 RCC.
Carcinoma, Renal Cell ; Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Recurrence ; Retrospective Studies