BACKGROUND: Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). The purpose of this study was to investigate the HAV vaccination status and related factors among college students. METHODS: The study subjects were 503 students conveniently sampled from C university located in one district of Jeollanamdo. General characteristics and HAV vaccination related factors were collected by a self-reported questionnaire in October 2013. Chi-square tests and multiple logistic regression analyses were used to evaluate related factors with HAV vaccination. RESULTS: Of the 503 subjects without a history of HAV infection, 65 subjects (12.9%) reported that they were vaccinated. In multiple analyses, subjects who have had health screening (adjusted odds ratio, aOR=2.44 and 95% confidence interval, 95% CI=1.26-4.73) and those who were aware of HAV infection (aOR=6.00, 95% CI=1.81-19.91) or who perceived the benefits of HAV vaccine (aOR=2.05, 95% CI=1.07-3.93) were more likely to be vaccinated than those not involved in these factors. With regard to intention for HAV vaccine, 314 subjects (71.9%) reported that they have the intention to be vaccinated against HAV. In multiple analyses, higher grade level, high monthly allowance, awareness of HAV vaccine, perceived susceptibility of HAV, perceived seriousness of HAV and perceived benefits of HAV vaccine were significantly associated with the intention for HAV vaccination. CONCLUSIONS: The vaccination rate for HAV was found to be low in our sample of college students. To reduce health risks related with HAV, prevention efforts should consider these results.
Communicable Diseases ; Hepatitis A ; Hepatitis A virus* ; Humans ; Intention ; Jeollanam-do ; Liver ; Logistic Models ; Mass Screening ; Odds Ratio ; Risk Factors ; Vaccination* ; Surveys and Questionnaires

BACKGROUND: The purpose of this study is to forecast changes in the prevalence of chronic diseases and health expenditure by age group. METHODS: Based on the Future Elderly Model, this study projects the size of Korean population, the prevalence of chronic diseases, and health expenditure over the 2014-2040 period using two waves (2012, 2013) of the Korea Health Panel and National Health Insurance Service database. RESULTS: First, the prevalence of chronic diseases increases by 2040. The population with hypertension increases 2.04 times; the diabetes increases 2.43 times; and the cancer increases 3.38 times. Second, health expenditure on chronic diseases increases as well. Health expenditure on hypertension increases 4.33 times (1,098,753 million won in 2014 to 4,760,811 million won in 2040); diabetes increases 5.34 times (792,444 million won in 2014 to 4,232,714 million won in 2040); and cancer increases 6.09 times (4,396,223 million won in 2014 to 26,776,724 million won in 2040). Third, men and women who belong to the early middle-aged group (44-55 years old) as of 2014, have the highest increase rate in health spending. CONCLUSION: Most Korean literature on health expenditure estimation employs a macro-simulation approach and does not fully take into account personal characteristics and behaviors. Thus, this study aims to benefit medical administrators and policy makers to frame effective and targeted health policies by analyzing personal-level data with a microsimulation model and providing health expenditure projections by age group.
Administrative Personnel ; Aged* ; Chronic Disease* ; Female ; Health Expenditures* ; Health Policy ; Humans ; Hypertension ; Korea ; Male ; National Health Programs ; Prevalence

Reactive arthritis occurs after a preceding infection such as urogenital or gastroenteral tract infection. Trichomoniasis, due to Trichomonas vasinalis infection, is one of the most common causes of vaginitis. Reactive arthritis associated with trichomoniasis is uncommon and there has been no report in Korea. We present a 28 year-old woman who had oligoarthritis after Trichomonas vaginalis infection. The arthritis subsided with treatment of the Trichomoniasis with metronidazole and non-steroidal anti-inflammatory drug.
Adult ; Arthritis ; Arthritis, Reactive* ; Female ; Humans ; Korea ; Metronidazole ; Trichomonas Infections ; Trichomonas vaginalis* ; Trichomonas* ; Vaginitis

Cytoplasmic Cu/Zn superoxide dismutase (SOD1) is an antioxidant enzyme that converts superoxide to hydrogen peroxide in cells. Its spatial distribution matches that of superoxide production, allowing it to protect cells from oxidative stress. SOD1 deficiencies result in embryonic lethality and a wide range of pathologies in mice, but little is known about normal SOD1 protein expression in developing embryos. In this study, the expression pattern of SOD1 was investigated in post-implantation mouse embryos and extraembryonic tissues, including placenta, using Western blotting and immunohistochemical analyses. SOD1 was detected in embryos and extraembryonic tissues from embryonic day (ED) 8.5 to 18.5. The signal in embryos was observed at the lowest level on ED 9.5-11.5, and the highest level on ED 17.5-18.5, while levels remained constant in the surrounding extraembryonic tissues during all developmental stages examined. Immunohistochemical analysis of SOD1 expression on ED 13.5-18.5 revealed its ubiquitous distribution throughout developing organs. In particular, high levels of SOD1 expression were observed in the ependymal epithelium of the choroid plexus, ganglia, sensory cells of the olfactory and vestibulocochlear epithelia, blood cells and vessels, hepatocytes and hematopoietic cells of the liver, lymph nodes, osteogenic tissues, and skin. Thus, SOD1 is highly expressed at late stages of embryonic development in a cell- and tissue-specific manner, and can function as an important antioxidant enzyme during organogenesis in mouse embryos.
Animals ; Cerebral Cortex/embryology/enzymology ; Copulation ; Cytoplasm/*enzymology ; Embryonic Development/*physiology ; Female ; Immunohistochemistry ; Lung/embryology/enzymology ; Male ; Mice ; Mice, Inbred ICR ; Organogenesis/*physiology ; Pregnancy ; Stomach/embryology/enzymology ; Superoxide Dismutase/deficiency/genetics/*metabolism

OBJECTIVE: Idiopathic inflammatory myopathies (IIMs) are systemic autoimmune diseases characterized by infiltration of T lymphocytes, monocytes, and macrophages in muscle tissues. Interleukin-17 (IL-17), a Th17 cytokine, has potent pro-inflammatory actions and plays a role in autoimmune diseases. We investigated the expression of IL-17 in muscle tissues of patients with IIMs. METHODS: We measured the IL-17 mRNA level of muscle tissues from 14 patients with IIMs (9 patients with dermatomyositis and 5 patients with polymyositis) by real-time RT-PCR and compared with controls. We also performed an immunohistochemical stain to detect IL-17 expression. RESULTS: The expressions of IL-17 were significantly enhanced in IIMs than controls. In immunohistochemistry, IL-17 was expressed in perimysial, endomysial and perivascular infiltrating inflammatory cells. CONCLUSION: These results suggest that IL-17 plays a role in the immunopathogenesis of IIMs.

OBJECTIVE: Rheumatoid arthritis (RA) is associated with an increased cardiovascular events. These may be related to insulin resistance (IR). We evaluated status of IR and analyzed the relationship between IR and clinical and laboratory characteristics in patients with RA. METHODS: We examined 52 RA patients (43 females) and 52 age and sex matched healthy controls. We measured Homeostasis model assessment (HOMA) IR, calculated according to fasting serum glucose and insulin. RESULTS: In patients, age was 50.8+/-10.2 years old, disease duration was 42.1+/-30.9 months. In controls, HOMA IR was 0.62+/-0.30 and in patients, it was 1.28+/-0.50. This difference was highly significant (p<0.001). Patients with early RA (disease duration is less than 36 months) were 28, and established RA (more than 36 months) were 24. HOMA IR was significantly higher in patients with established RA (1.42+/-0.45) than those with early RA (1.16+/-0.45) (p=0.03), and significantly correlated with disease duration (r=0.36, p=0.01), BMI (r=0.36, p<0.001), total cumulative prednisolon dose (r=0.34, p=0.01). Disease duration and BMI were independent predictors for HOMA IR (p<0.01, p=0.03). CONCLUSION: In patients with RA, IR measured by HOMA IR was more significantly increased than that of healthy control and significantly correlated with disease duration, BMI, and total cumulative prednisolon dose; however, the determinants of HOMA IR in RA patients were disease duration and BMI.
Arthritis, Rheumatoid ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance

Objective: To investigate the expression of toll-like receptor (TLR)-2, 4 and 9 in idiopathic inflammatory myopathies (IIMs). Methods: The expression of TLR-2, 4 and 9 was measured by real-time RT-PCR and immunohistochemical stain (IHS) from muscle tissues in patients with IIMs and controls. Results: The expression levels of TLR-2, 4 and 9 in IIMs were significantly higher than controls. TLR-2, 4 and 9 were mainly expressed on sarcolemma of muscle fibers, perimysial vascular endothelium and infiltrating inflammatory cells in dermatomyositis, whereas, they were mainly expressed on sarcolemma of muscle fibers, destructed muscle fibers, and enodmysial infiltrating inflammatory cells in polymyositis. Conclusion: TLR-2, 4 and 9 were highly expressed in muscle tissue of IIMs. These results suggest that TLR-2, 4 and 9 play a role in pathogenesis of IIMs.
Dermatomyositis ; Endothelium, Vascular ; Humans ; Myositis* ; Polymyositis ; Sarcolemma ; Toll-Like Receptors*

A carcinosarcoma of the esophagus is an uncommon malignancy accounting for approximately 1~2% of all esophageal neoplasms. Histologically, both carcinomatous and sarcomatous components are observed. The terms used to describe this lesion include carcinosarcoma, pseudosarcoma, polypoid carcinoma, pseudosarcomatous carcinoma pseudosarcomatous squamous cell carcinoma and a spindle cell variant of a squamous cell carcinoma. It presents as a bulky intraluminal polypoid lesion mainly in the mid to lower esophagus. It often presents relatively early because of its rapid intraluminal growth. Ultimately, the treatment is similar to that of an esophageal carcinoma requiring an esophagectomy for resectable lesions. We report a case of a 64-year-old man with a carcinosarcoma of the esophagus. Endoscopy revealed a 1.5 cm sized polypoid mass located 25 cm from the incisor with friable nature. Radiological studies revealed a bulky polypoid intraluminal mass with a lobulated border, measuring approximately 7 cm in length, in the mid esophagus that expands the lumen in conjunction with the enlargement of the regional lymph nodes. An esophagectomy was performed.
Carcinoma, Squamous Cell ; Carcinosarcoma* ; Endoscopy ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Incisor ; Lymph Nodes ; Middle Aged

OBJECTIVE: To determine the feasibility, safety, advantages and limitations of laparoscopic management of adnexal masses in pregnancy by comparing with laparotomy. METHODS: Between Jan 2001 to Jan 2003, 36 laparoscopic procedures and 15 laparotomy procedures were performed in 51 patients with adnexal masses in pregnancy. Operation time, hospital stay, pathologic findings, complications and pregnancy outcome were analyzed in these patients. RESULTS: Most common pathologic finding was mature cystic teratoma (45%) and malignancy of adnexal tumors were 3 cases (5.9%). There were no differences in size of adnexal tumor, operation time, hemoglobin level change after operation, gestational age at delivery, birth weight, Apgar score, preterm delivery and fetal anomaly between the two groups. Hospital stays was shorter and gestational age at operation was earlier in laparoscopy than explolaparotomy. CONCLUSION: Laparoscopic management of adnexal masses in pregnancy is safe and effective procedure.
Apgar Score ; Birth Weight ; Female ; Gestational Age ; Humans ; Laparoscopy* ; Laparotomy* ; Length of Stay ; Pregnancy Outcome ; Pregnancy* ; Teratoma

Background and Objectives: Endoscopic prelacrimal recess approach (PLRA) was introduced to treat maxillary sinus inverted papilloma (IP) without sacrificing the inferior turbinate and nasolacrimal duct. This study aimed to compare surgical outcomes of prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove IP of maxillary sinus and to evaluate the usefulness of the PLRA.Subjects and Method We retrospectively reviewed medical records of 51 patients who were treated in our institution for IP of nasal cavity and sinuses between March 2010 and June 2019. Twenty patients had maxillary sinus IP. Sixteen patients underwent endoscopic sinus surgery combined with either CLA (n=8) or PLRA (n=8). Demographic data, surgical technique, site of IP origin, intra- and postoperative complications, duration of follow-up, recurrence rate and pathologic diagnosis were reviewed. Results: IP was the pathologic diagnosis for all 16 cases. Gross total removal was achieved in all cases. The mean follow-up period was 20.1 months in CLA group and 12.5 months in PLRA group. There was one case of massive bleeding during operation requiring transfusion and postoperative ICU care in CLA group. On postoperative follow-up, two patients from the CLA group had recurrence during the follow-up period. One patient had numbness around the gingival area, another patient had transient wound dehiscence, and another had persistent oro-antral fistula. In PLRA group, one patient had periorbital swelling after blowing nose; otherwise, no other patient from the PLRA group developed subjective complaints after surgery. Conclusion Endoscopic prelacrimal recess approach showed lower complication rates and recurrence rates compared to CLA. PLRA is a safe and effective method for the excision of primary maxillary sinus IP.