Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.
Advance Directives* ; Aging ; Surveys and Questionnaires ; Delivery of Health Care ; Health Care Costs ; Health Personnel ; Humans ; Korea ; Patient Rights ; Prevalence ; Quality of Life

Colorectal cancer can have a gross appearance similar to linitis plastica of the stomach. However, most of these cases are not primary colorectal lesions but are, indeed, metastases from other sites. This study was designed to answer the following questions; (1) Why is the linitis plastica of the large intestine so rare compared to that of te stomach? (2) Which part of the large intestine is predominantly affected by linitis plastical form? (3) Is the histogenesis of linitis plastica involving the lagre intestine similar to that involving the stomach? Of the 911 cases of the resected colorectal primary cancer, we found only 4 cases of primary linitis plastica of the intestine (0.4%) and another one case referred from other hospital. All involved the rectum; they were of encircling carcinoma with diffuse transmural infiltration of signet ring cell carcinoma accompanied by marked desmoplasia as in the gastric form. Signet ring cell carcinoma of the large intestine comprised 1.8%(n=16) of the total colorectal cancer(n=911), and predominantly occurred in the rectum(n=8). There was no histologic difference between the linitis plastica in both stomach and colon in terms of desmoplastic reaction, once the tumor infiltrated into the submucosa. We conclude that rarity of signet ring cell carcinoma in the large intestine together with its predominant occurrence in the rectum can explain low incidence of primary colorectal linitis plastica and high preference in the rectum.
Incidence ; Neoplasm Metastasis

No abstract available.
alpha-Fetoproteins* ; Infant, Newborn ; Jaundice, Neonatal* ; Plasma*

This study examined the effectiveness of two commonly used dietary assessment methods (the 24-hour recall and the food frequency questionnaire) in the epidemiological investigations of health-related habits and degenerative diseases. This cross sectional project in the Seoul area was conducted for the purpose of establishing cohort subjects and collecting reliable nutrient intake data for a further large-scale cross sectional study. The subjects were 91 volunteers from the Seoul area with a mean age of 53.5 +/- 9.6 for the males and 52.2 +/- 8.9 for the females. The subjects had a rela-tively high educational background, were from high socioeconomic levels, and were greatly concerned about healthrelated life styles. There was a significantly negative correlation between their smoking and their nutrient intake. Their drinking habits, their self-estimated health status and their concern or stress about being healthy did not have any influence on their nutrient intakes. Skipping meals was the most undesirable dietary habit influencing their nutrient intakes, and the next was their irregularity of eating meals. The subjects who liked legumes and fish had higher intakes of iron and niacin and those who liked milk and dairy products had higher intakes of calcium, vitamin B2 and fat. The subjects who considered themselves not to be healthy consumed higher amounts of fish and shell-fish, and those who considered themselves to be healthy consumed higher amounts of vegetables. The smokers consumed less fruits than non-smokers, but there was no correlation between their drinking and consumption of the food groups. There was no correlation between their food consumption frequency and their skipping meals or meal irregularity. There were positive correlations between their food likes and food consumption frequency for foods such as meat, milk and dairy products, seaweeds and fruits. Therefore, their smoking, skipping meals and meal irregularity appeared to greatly influence their nutrient intakes. Significant correlations were found between their health-related habits and their food group preferences and food frequencies. This implies that simple surveying methods using criteria such as smoking, skipping meals and meal irregularity, food group preferences and eating frequencies can be used as useful tools in the assessment of nutritional statuses.
Calcium ; Cohort Studies ; Dairy Products ; Drinking ; Eating ; Fabaceae ; Female ; Food Habits ; Fruit ; Humans ; Iron ; Life Style ; Male ; Meals ; Meat ; Milk ; Niacin ; Nutritional Status ; Riboflavin ; Seoul* ; Smoke ; Smoking ; Vegetables ; Volunteers

In order to analyze the occlusion of TMD patient, 73 casts and post eroanterior cephalometric X-rays of patients showing TMD symptoms at first interview were measured and compared that of 30 non-patients. Horizontal overjet, vertical overbite, openbite, crossbite, depth of curve of Spee, midline deviation, facial asymmetry, attrition, and TPI were measured and processed statistically. The results could be summarized as follows, 1. TMD group showed the highest prevalence in twenties, teens, and before 9 years old group in order, and more prevalent in female than male. 2. There were no statistically significance between two groups of overjet and overbite measurements, but showed significance of 6 classification of anterior tooth relationship between two groups TMD groups. 3. TMD group had more anterior openbite than normal group but there were no statistically significance between two groups. 4. Anterior crossbite was more prevalent in normal group but posterior crossbite was more prevalent in TMD group. 5. TMD group showed deeper curve of Spee and there were statistically significance between two groups. 6. TMD group had more attrition than normal group and there were statistically significance beween two groups. 7. TMD group showed more facial asymmetry than normal group. 8. TPI did not showed statistical significance between two groups. According to the above results, TMD group showed severe and complex mode of malocclusion and this should be carefully regarded when treatment planning and during the treatment of malocclusion.
Adolescent ; Child ; Classification ; Dentition* ; Facial Asymmetry ; Female ; Humans ; Male ; Malocclusion* ; Open Bite ; Overbite ; Prevalence ; Tooth

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

No abstract available.
Lung* ; Neoplasm Metastasis* ; Sarcoma* ; Thorax*

It is reported that a fermented soybean food, Doenjang, has strong antimutagenic and cytotoxic effect on cancer cells. This study investigated the effect of Chungkookjang, another traditional popular Korean soybean fermented food, on growth of cancer cells: HL-60, SNU-638 and MCF-7, and also its in vivo antitumorigenic effect in DMBA-induced mammary tumor rat model. For the in vitro study, Chungkookjang and steamed soybeans were extracted with ethanol and sequentially fractioned with 5 kinds of solvents differing in grades of polarity such as hexane, dichloromethane, ethylacetate, butanol and water. Almost all Chungkookjang extracts significantly inhibited the growth of HL-60 (human leukemic cancer cell), SNU-638 (human gastric cancer cell) and MCF-7 (human breast cancer cell) when compared to steamed soybean extracts. Butanol fraction of Chungkookjang extract especially showed a remarkable inhibitory effect in all the three kinds of cancer cells. To induce a mammary gland tumor, DMBA (50 mg/BW) was administered to 50 day-old female rats and followed by Chungkookjang or steamed soybean supplemented diets. Freezedried Chungkookjang powder (20% of diet in wet weight) was added to AIN-93G based diet for the Chungkookjang group of rats. Likewise, steamed soybean powder containing equal protein content to that of Chungkookjang powder was supplemented to soybean group of rats. At 13 weeks later, the mammary tumor incidence, average tumor number and tumor weight a rat were lower in Chungkookjang group compared to the control or soybean group. In conclusion, Chungkookjang showed a strong inhibitory effect on cancer cell growth in vitro, as well as a more preventive effect against chemically induced mammary tumorigenesis in vivo, while steamed soybeans did not. Therefore, these results suggest that Chungkookjang acquire its anticancer activity through the fermentation process.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Breast Neoplasms ; Carcinogenesis ; Diet ; Ethanol ; Female ; Fermentation ; Humans* ; Incidence ; Mammary Glands, Human ; Methylene Chloride ; Models, Animal ; Rats* ; Solvents ; Soybeans* ; Steam ; Stomach Neoplasms ; Tumor Burden ; Water

No abstract available.
Animals ; Embryonic Structures* ; Fertilization in Vitro* ; Fetal Blood* ; Humans* ; Mice* ; Quality Control* ; Sperm Motility* ; Spermatozoa*

During childhood, meningioma is an uncommon tumor, and in infants, extracranial meningioma is very rare. We report a case of primary cutaneous menigioma occurring on the scalp of a ten-month-old girl.
Female ; Humans ; Infant* ; Meningioma* ; Scalp*