BACKGROUND: The purpose of this study was to investigate how educational status influences cardiovascular risk factors and care of diabetes mellitus and hypertension. METHODS: From Korean National Health and Nutrition Survey IV, we obtained survey results of 6,835 men and 9,067 women more than 30 years old. We performed multivariate logistic regression to compare cardiovascular risk factors and care of hypertension and diabetes respective to educational status. RESULTS: There were disparities in cardiovascular risk factors by educational status. In men, impaired fasting glucose, high triglyceride, and smoking were less frequently found in the highest educated group than in the middle educated group. In women, the prevalence of abdominal obesity, impaired fasting glucose, high blood pressure, high triglyceride, and metabolic syndrome among the highest educated group were significantly lower. The proportion of those with proper physical activity in the highest educated group was found to be less than that of the middle educated group, regardless of gender. For care of diabetes mellitus and hypertension, disease recognition and treatment were lower among the lowest educated group in men, while these disparities were not shown in women. Instead, the lowest educated group in diabetic women received screening exams for eye and kidney complications less than the middle education group. In both genders, the high education group had a higher chance of receiving education about diabetes mellitus. CONCLUSION: There were educational disparities in cardiovascular risk factors and care of hypertension and diabetes mellitus. The disparities were found to be different by gender.
Cardiovascular Diseases ; Diabetes Mellitus ; Educational Status ; Eye ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Kidney ; Logistic Models ; Male ; Mass Screening ; Motor Activity ; Nutrition Surveys ; Obesity, Abdominal ; Prevalence ; Quality of Health Care ; Risk Factors ; Smoke ; Smoking

No abstract available.
Animals ; Female ; In Situ Hybridization ; Mice* ; Ovary*

PURPOSE: The survival after a pancreaticoduodenectomy, for a periampullary adenocarcinoma is limited. However, the improvement in perioperative management, and the development of interventional medicine have made the survival from that cancer favorable. Due to the anatomical proximity of periampullary tumors, surgeons perform same procedure. It is accepted that the outcome of periampullary cancers vary after resection. The purpose of this study was to evaluate the risk factors, and the differences in survival, from periampullary cancers according to the origin of the tumor. METHODS: From March 1992 to December 2000, 87 patients, with periampullary tumors, who underwent a pancreatico duodenectomy, were analyzed for the location of the tumor and the tumor status. Of the 87 patients, the 85 surviving more than 30 days were included in the statistic analysis. The survival was calculated using the Kaplan-Meier Method. The risk factors were also analyzed between the locations. RESULT: Of the 87 resected adenocarcinomas, 25 were pancreatic cancers, 30 distal CBD (common bile duct) cancers, 26 mpulla of Vater cancers and 6 duodenal cancers. The patients had a mean age of 60 (40~78) years. The total bilirubin, ALT, and CA 19-9 levels were statistically different for each cancer. There were no statistical differences between the cancer groups in operative methods, the amount of transfusion, postoperative hospital stay, and complications. The overall morbidity and mortality were 37 and 2%, respectively. The 5-year survival rates for the pancreatic, distal CBD, and Ampulla of Vater cancers were 9.6, 45.5, and 72.1%, respectively, was and were statistically significant (P<0.001). A univariate analysis of the 85 patients indicated that the predictors of long term survival included: a pathologic diagnosis of Ampulla of Vater cancer, absence of lymph node metastasis, tumor diameter<3 cm and complication. CONCLUSION: The factors influencing the survival were nodal metastasis, size of the tumor, age, and complications. The differences in the tumor biology will affect the survival, and although a pancreaticoduodenectomy remains the procedure of choice for periampullary tumors, adjuvant, or neoadjuvant, therapy for a pancreatic head tumor is especially needed.
Adenocarcinoma ; Ampulla of Vater ; Bile ; Bilirubin ; Biology ; Diagnosis ; Head ; Humans ; Length of Stay ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreaticoduodenectomy* ; Prognosis* ; Risk Factors ; Survival Rate

Appendicular schwannoma is a rare tumor originating from Schwann's cells in the Auerbach plexus. The preoperative diagnosis is difficult because the clinical features are nonspecific, and it is mostly found accidentally via a radiologic image as a tumor, mimicking malignancy. We report a case of an appendicular schwannoma coexisting with an adenocarcinoma in the lung. A laparoscopic appendectomy was done with a clear resection margin, and the immunohistochemical staining showed positive S-100 protein, which confirmed the schwannoma. The patient also underwent a left upper lobectomy of the lung. The patient has been free of recurrence for the 6 months since the operation. The laparoscopic approach could be available for treatment of an appendicular schwannoma, thus avoiding an unnecessary laparotomy.
Adenocarcinoma ; Appendectomy ; Appendix ; Humans ; Laparoscopy ; Laparotomy ; Lung ; Myenteric Plexus ; Neurilemmoma ; Recurrence ; S100 Proteins

BACKGROUND AND AIM: Hepatitis B virus and hepatitis C virus were known as risk factors of hepatocellular carcinoma( HCC). Through past epidemiological and molecular biologic studies, the pathogenesis of HCC related with hepatitis viruses has been investigated. However the clinical features of the patients with HCC according to viral infections have not been established well. The aim of this study was to evaluate the clinical features and surgical outcomes in hepatocellular carcinoma related with hepatitis B and/or C. METHODS: We retrospectively reviewed the medical records of 411 patients who underwent the hepatic resections for hepatocellular carcinoma at Seoul National University Hospital between 1990 and 1997. We checked preoperative clinical features, preoperative laboratory tests, operative findings, postoperative pathologic reports, recurrences and survivals. According to the presence of hepatitis B surface antigen(HbsAg) and antibody of heptitis C virus(anti-HCV Ab), we divided into 4 groups: Non B C group(HbsAg(-) and anti-HCV Ab (-) n=61), B group (HBsAg (+) and anti-HCV Ab (-) n=275), C group(HBsAg (-) and anti-HCV Ab (+) n=62), B C group(HBsAg (+) and anti-HCV Ab (+) n=13). RESULTS: C group were older than B group (62.6+/-6.0 years vs. 50.5+/-9.3 years, p=0.005) and had poorer hepatic functions than B group; serum albumin level(3.52+/-0.32 g/dl vs. 3.69+/-0.40 g/dl, p=0.006), aspatate aminotransferase (108.50+/-114.36 IU/L vs. 59.63+/-60.80 IU/L, p=0.015), alanine aminotransferase (99.477+/- 7.82 IU/L vs. 65.59+/-86.39 IU/L, p=0.032), prothrombin time (83.2+/-16.4% vs. 91.3+/-14.4%, p=0.006), ICG R15 ( 18.83+/-9.02% vs. 9.19+/-7.98%, p=0.001). Pathologic results showed that C group has smaller sizes(3.5+/-2.6 cm vs. 4.6+/-3.0 cm, p<0.05), less encapsulated (68.2% vs. 80.9%, p=0.001), more multiple lesions(27.4% vs. 9.1%, p=0.001) than B group. The survival rate of B,C group was significantly lower than that of B group(5- year cumulative survival rate: 32.0% vs. 58.0%, p=0.029). Otherwise, there were no differences in recurrence rates, disease free survival rates and overall survival rates among four groups. CONCLUSION: The patients with anti-HCV Ab positive had poorer hepatic functions and older age than other patients. And the patients who had combined infections with hepatitis B and C had poorer outcome. More careful pre- and post- operative follow-up is needed in these patients.
Alanine Transaminase ; Carcinoma, Hepatocellular* ; Disease-Free Survival ; Follow-Up Studies ; Hepacivirus ; Hepatitis B virus ; Hepatitis B* ; Hepatitis C ; Hepatitis Viruses ; Hepatitis* ; Humans ; Medical Records ; Prothrombin Time ; Recurrence ; Retrospective Studies ; Risk Factors ; Seoul ; Serum Albumin ; Survival Rate

OBJECTIVES: To investigate whether endometrial proteins with molecular weight(MW) of 92 kilodalton(kDa) may be a specific antigen involved in autoimmunity in endometriosis and to evaluate the efficacy of enzyme-linked immunosorbent assay(ELISA) in determining antiendometrial antibodies, compared with Western blot. METHODS: Sera of forty-eight patients with endometriosis, 21 patients with normal control patients, 7 patients with Mayer-Rokitansky-Kustner-Hauser(MRKH) syndrome and cord sera of 22 male neonates(experimental controls) were tested for the presence of antibodies against endometrial proteins by Western blot and ELISA. All statistics were performed by Fishers exact teast and Student's t-test. RESULTS: Fourteen(29.1%), 18.8%, and 33.3% of sera from patients with endometriosis had immunoglobulin (IgG) antibodies that were reactive against endometrial proteins of MW of 71, 92, 103 kDa while any sera from experimental controls did not show any reactivity against these antigens. Overall, threr were specific IgG antiendometrial antibodies detectable by Western blot in 56.3% of patients with endometriosis and in a normal eontrol patient. The binding activities of serum IgG to endometrial proteins were higher in patients with endometriosis than other groups. Circulating IgG antiendometrial antibodies were detected by ELISA in 54.3% of 35 patients with endometriosis and in 2 normal control patients. The concordance rate between ELISA and Western blot in determining the presence of antiendometrial antibodies was 78.3%. CONCLUSIONS: Ninety-two kDa endometrial protein is a specific antigen eliciting IgG responses in endometriosis. ELISA may be an useful method in screening autoimmune endometriosis.
Antibodies* ; Autoimmunity ; Blotting, Western* ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G ; Immunoglobulins ; Male ; Mass Screening

In this study, we evaluated the effect of grid size on dose calculation accuracy using 2 head & neck and 2 prostate IMRT cases and based on this study's findings, we also evaluated the efficiency of a 2D diode array detector for IMRT quality assurance. Dose distributions of four IMRT plan data were calculated at four calculation grid sizes (1.25, 2.5, 5, and 10 mm) and the calculated dose distributions were compared with measured dose distributions using 2D diode array detector. Although there was no obvious difference in pass rate of gamma analysis with 3 mm/3% acceptance criteria for the others except 10 mm grid size, we found that the pass rates of 2.5, 5 and 10 mm grid size were decreased 5%, 20% and 31.53% respectively according to the application of the fine acceptance criteria, 3 mm/3%, 2 mm/2% and 1 mm/1%. The calculation time were about 11.5 min, 4.77 min, 2.95 min, and 11.5 min at 1.25, 2.5, 5, and 10 mm, respectively and as the grid size increased to double, the calculation time decreased about one-half. The grid size effect was observed more clearly in the high gradient area than the low gradient area. In conclusion, 2.5 mm grid size is considered acceptable for most IMRT plans but at least in the high gradient area, 1.25 mm grid size is required to accurately predict the dose distribution. These results are exactly same as the precious studies' results and theory. So we confirmed that 2D array diode detector was suitable for the IMRT QA.
Head ; Neck ; Prostate

No abstract available.
Animals ; Female ; Mice* ; Ovary*

BACKGROUND: Mutations in mitofusin2 (MFN2) are a major underlying cause of axonal Charcot-Marie-Tooth neuropathy (CMT). It has been reported that patients with an early age of onset (<10 years, EO) show more severe clinical phenotypes than those of patients with a later age at onset (> or =10 years, LO) in CMT2A with MFN2 mutations. There are few studies about CMT patients with MRI studies and we performed leg MRIs for better understanding of CMT2A. METHODS: We identified 19 patients (EO=10; LO=9) with MFN2 mutations. We used functional disability scales and CMT neuropathy scales for the grading of disability. Nerve conduction studies and MRIs of the lower leg were performed in all patients. RESULTS: We confirmed that EO had more severe leg muscle involvement than LO by leg MRI. In 7 out of 9 in LO, there were some degree of asymmetric leg muscle weakness and MRI findings explained the nature of asymmetry, that is, asymmetric cross-sectional areas or fatty infiltration. MRI of EO showed marked fatty infiltration on all three compartments whereas that of LO showed rather selective involvement of the posterior compartment. These results were well correlated with clinical findings that in LO, five patients could not do toe walking whereas only one could not do heel walking. CONCLUSIONS: MRI of the leg may be a useful tool for evaluating axonal CMT neuropathy, and asymmetric leg muscle weakness may be the characteristics of an axonal CMT. In addition, more prominent involvement of the posterior leg in LO is a very interesting phenomenon, which is in contrast to the length-dependent involvement in congenital demyelinating neuropathy.
Age of Onset ; Axons* ; Charcot-Marie-Tooth Disease ; Heel ; Humans ; Leg* ; Magnetic Resonance Imaging* ; Muscle Weakness ; Neural Conduction ; Phenotype ; Toes ; Walking ; Weights and Measures

OBJECTIVE: The aim of this study is to compare the efficacy of the TVT and TOT which have been widely used in the surgical management of stress urinary incontinence. METHODS: The study was carried on 22 patients with stress urinary incontinence who had operation at Seoul National University Bundang Hospital from April to December 2004. Review of medical records was done and clinical characteristics were compared according to the operation procedure. RESULTS: The TVT was done on 11 patients and TOT on 11 patients. There were no significant differences in patients' age, parity, body mass index, menopausal status, and severity of incontinence. The operation time was significantly shorter in TOT than in TVT. Complication rate and hospital stay were not significantly different between TVT and TOT. The cure rate (patients' satisfaction) was 90.9% in TVT, 100% in TOT. CONCLUSION: The TVT and TOT are both effective surgical treatment for stress urinary incontinence. The TOT is simple and time saving procedure because it can be done without cystoscope.
Body Mass Index ; Cystoscopes ; Female ; Humans ; Length of Stay ; Medical Records ; Parity ; Seoul ; Suburethral Slings* ; Urinary Incontinence*