OBJECTIVES: The purpose of this study was to identify the factors influencing the intention to have stomach cancer screening using the theory of planned behavior (TPB) in Korea. METHODS: For this population-based study, 1,535 adult respondents (aged 40 to 70 years) were recruited using multi-stratified random sampling and a face-to-face administered questionnaire. This study was based on Ajzen's theory of planned behavior. Intentions were divided into three scenarios for fee payment in the next two years: (1) free of charge, (2) co-payment, and (3) full charge. Multiple linear regression was used to identify the factors influencing the intention to have stomach cancer screening. RESULTS: Perceived behavioral control and attitude toward stomach cancer screening were significant predictors of the intention to have stomach cancer screening. However, subjective norm only influenced the intention to have stomach cancer screening with full charge in the next two years. CONCLUSIONS: The results suggest that attitude and perceived behavioral control are likely to contribute toward increasing the intention to have stomach cancer screening. Especially, perceived behavioral control is a good predictor. Because the study subjects were nation wide residents, the study results can be generalized.
Adult ; Aged ; Female ; Health Expenditures ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Male ; Middle Aged ; *Patient Acceptance of Health Care ; Stomach Neoplasms/*diagnosis

BACKGROUND: When local anesthetics for regional anesthesia is used, usually small amounts of bicarbonate are added for rapid onset. This addition gives the mixed solution a more alkaline pH. The following result is an increased unionized form of the local anesthetic and rapid penetration of the drug into tissue. Unfortunately, no data about adequate mixing volumes of domestic lidocaine and bicarbonate is available. METHODS: We examined six mixing pairs of two kinds of 2% lidocaines and three kinds of 8.4% bicarbonates for minimum volumes of bicarbonate to cause a precipitation of 2% 20 ml lidocaine. RESULTS: The mean volumes of bicarbonate to cause precipitation were 1.54 ml for Kwang-Myung lidocaine with Kwang-Myung bicarbonate, 2.90 ml for Kwang-Myung lidocaine with Dae-Won bicarbonate, 2.73 ml for Kwang-Myung lidocaine with Je-Il bicarbonate, 0.97 ml for Je-Il lidocaine with Kwang-Myung bicarbonate, 1.26 ml for Je-Il lidocaine with Dae-Won bicarbonate and 1.39 ml for Je-Il lidocaine with Je-Il bicarbonate. CONCLSIONS: We conclude that the Kwang-Myung lidocaine and the Je-Il lidocaine could cause precipitation when mixing with a smaller bicarbonate volume than foreign textbook recommended.
Anesthesia, Conduction ; Anesthetics, Local ; Bicarbonates ; Hydrogen-Ion Concentration ; Lidocaine

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

PURPOSE: Eosinophilia may be associated with various primary and reactive conditions. However, studies on the cause and incidence of eosinophilia in Korean children are rare. This study aimed to evaluate the cause and incidence of eosinophilia in patients at a single university hospital. METHODS: We studied 8,285 pediatric patients under the age of 18 years who had eosinophilia at Pusan National University Hospital. Premature and newborn infants were excluded. Eosinophilia was defined as an absolute eosinophil count greater than 450/microL. Eosinophilia was categorized as mild (450-1,500/microL), moderate (1,500-5,000/microL), and severe (>5,000/microL). The underlying conditions of eosinophilia were retrospectively investigated. RESULTS: Of 8,285 patients who had a hematology profile, 497 (5.9%) were found to have eosinophilia. Of patients with eosinophilia, 333 patients (67.0%) had identifiable and possible causes. The major causes of eosinophilia were allergic diseases (61.3%), infectious diseases (19.8%), immunologic diseases (9.0%) and hemato-oncologic disease (5.1%). Immunological disease such as Idiopathic hypereosinophilic syndrome, drug induced hypersensitivity syndrome and Graft-versus-host disease was the common condition with moderate to severe eosinophilia in which eosinophil count in peripheral blood was more than 1,500/microL. CONCLUSION: The most common cause of eosinophilia was allergic disease. Immunological disease was the common condition with moderate to severe eosinophilia.
Busan ; Child* ; Communicable Diseases ; Eosinophilia* ; Eosinophils ; Graft vs Host Disease ; Hematology ; Humans ; Hypereosinophilic Syndrome ; Hypersensitivity ; Immune System Diseases ; Incidence* ; Infant, Newborn ; Retrospective Studies

OBJECTIVE: To investigate the relationship between the transcallosal fibers (TCFs) from the corticospinal tract (CST) and the motor function of the affected extremities in patients with cerebral hemorrhage, using diffusion tensor image tractography (DTT). METHOD: 49 patients with cerebral hemorrhage and 38 controls were recruited. DTT was performed using 1.5 T magnetic resonance imaging. The DTT findings were classified into 3 groups according to targeting location: no TCF from the CST (type A), TCF ended in the corpus callosum or connected to the cortex of the opposite hemisphere (type B), and TCF that descending toward the lesion after passing through the corpus callosum (type C). RESULTS: The TCF originated from the CST of the unaffected hemisphere, and the presence of fiber descending toward the lesion after passing through the corpus callosum were significantly more prevalent in the patients who showed the worse motor function. CONCLUSION: The TCF originated from the unaffected CST toward the lesion in patients with cerebral hemorrhage might play a relevant role in compensating motor deficits in the major corticospinal disruption.
Cerebral Hemorrhage ; Corpus Callosum ; Diffusion ; Extremities ; Humans ; Magnetic Resonance Imaging ; Pyramidal Tracts

BACKGROUND: Acute pyelonephritis (APN) is an unusual cause of acute renal failure (ARF) in patients without urinary obstruction and other predisposing conditions. Therefore, in the differential diagnosis of ARF, APN is rarely considered. METHODS: We retrospectively analyzed the data from the patients with ARF secondary to APN (ARF group, n=8) with normal renal anatomy and no known predisposing conditions which lead to ARF during the course of acute bacterial pyelonephritis, and investigated the differences of clinical parameters to the patients with uncomplicated APN (control group, n=20). RESULTS: Female were predominant in both groups. The mean age was 49.2+/-14.4 years in control group and 56.3+/-16.4 years in ARF group. On admission, the body temperature was 37.5+/-1.14degrees C in control group and 36.62+/-0.32degrees C in ARF group (p= 0.003). The days of pyuria, duration days of costovertebral angel (CVA) tenderness and hospitalization days were significantly prolonged in ARF group. CVA tenderness was unilateral in 65% of control group and bilateral in 65% of ARF group. Amounts of daily urine protein excretion were 0.15+/-0.48 gm/ day in control group and 2.99+/-2.89 gm/day in ARF group (p=0.001). Creatinine clearance and FeNa were 24.04+/-15.98 mL/min and 2.80+/-2.68 in patients group, respectively. Development of ARF had positive correlation with the duration of pyuria (r=0.579, p< 0.01), amounts of daily urine protein excretion (r=0.854, p< 0.01), duration of CVA tenderness (r=0.461, p< 0.05) and had a negative correlation with body temperature (r=-0.402, p< 0.05). CONCLUSION: APN is a rare but important cause of acute renal failure. Patients with ARF secondary to APN seems to have more prolonged period of pyuria and CVA tenderness, apyrexia and excrete more protein in urine than patients with uncomplicated APN. Adequate treatment of the bacterial infection by prompt antibiotic treatment may lead to full recovery of renal function.
Acute Kidney Injury* ; Bacterial Infections ; Body Temperature ; Creatinine ; Diagnosis, Differential ; Female ; Hospitalization ; Humans ; Pyelonephritis* ; Pyuria ; Retrospective Studies

OBJECTIVES: The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea. METHODS: A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of \'over mild depression' in a follow-up survey. RESULTS: The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73-37.22]). In contrast, job stress from a \'difficult physical environment' revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04-0.92]). CONCLUSIONS: Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.
Depression* ; Firefighters* ; Follow-Up Studies ; Healthy Worker Effect ; Humans ; Korea ; Male* ; Mental Health ; Odds Ratio ; Republic of Korea ; Risk Factors

OBJECTIVE: To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. MATERIALS AND METHODS: US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. RESULTS: There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. CONCLUSION: US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where microcalcifications are visible with the use of high-resolution US.
Adult ; Aged ; *Biopsy/methods ; Breast/*pathology ; Breast Neoplasms/*diagnosis/pathology/radiography ; Calcinosis/*pathology ; Female ; Humans ; Mammography ; Middle Aged ; *Ultrasonography, Interventional ; Ultrasonography, Mammary ; Vacuum

A 59-year-old female was admitted with left flank pain. She had heat intolerance and dyspnea for the last 3 years. She was diagnosed as having renal and splenic infarction. 2 phase computed tomography (CT) scan on abdomen and pelvis showed a non-enhancing portion at the anterior aspect of the left kidney and multifocal low density at the spleen. Laboratory examinations revealed TSH 0.0004 uIU/mL, Free T4 2.69 ng/dL, T3 1.67 ng/mL, anti TPO antibody 207 U/mL (positive), anti TG antibody 52.7 U/mL (positive) and TSH receptor antibody >40 U/mL. A diagnosis of hyperthyroidism was made. Factor VIII activity increased over 160% (normal range 60-140), which has been known to increase in the cases of hyperthyroidism. Except for an increased factor VIII activity there were no thrombogenic abnormalities. She recovered well after the treatment with methimazole in addition to warfarin followed by intravenous heparin. This case is consistent with the assumption that hyperthyroidism, probably through a factor VIII-mediated hypercoagulability, may be a predisposing factor for the development of renal and splenic infarction.
Abdomen ; Dyspnea ; Factor VIII ; Female ; Flank Pain ; Heparin ; Hot Temperature ; Humans ; Hyperthyroidism ; Immunoglobulins, Thyroid-Stimulating ; Infarction ; Kidney ; Methimazole ; Middle Aged ; Pelvis ; Receptors, Thyrotropin ; Spleen ; Splenic Infarction ; Thrombophilia ; Warfarin

BACKGROUND: It is known that non-steroidal antiinflammatory drugs (NSAIDs) reduce the amount of proteinuria in nephrotic syndrome. It is based on the facts that the NSAIDs block the production of prostaglandins. Therefore selective cyclooxygenase-2 (COX-2) inhibitor may be expected to play a role in reduction of the proteinuria in nephrotic syndrome. METHODS: Twenty-seven Sprague-Dawley rats were divided into 3 groups. After 3 to 5 days of adaptation, we gave puromycin aminonucleoside to groups A and B via intraperitoneal route. The third group C was a normal control group. Selective COX-2 inhibitor was orally given to group A for 2 weeks. Each group was divided again into 3 subgroups by the day of experiment: 1, 14 and 21-day subgroups. We checked the changes in the serum and urine creatinine, albumin concentrations, creatinine clearances, the amount of proteinuria and the pathologic findings. The differences between groups were tested by 2-way ANOVA and Dunnett T-test, and the changes of proteinuria were tested by Repeated measures ANOVA. RESULTS: The changes of 24-hour urine protein excretion were significantly different between three groups (p<0.01). Protein excretion of group A was significantly decreased, especially between 14 and 21 days (p<0.05). The changes of creatinine clearance were significantly different between three groups (p<0.05), between 1 and 21 days (p<0.05). Electron microscopy showed morphological recovery of foot processes after administration of selective COX-2 inhibitor in PAN nephropathy rats (group A). CONCLUSION: It is suggested that selective COX- 2 inhibitors may be effective in reducing proteinuria and protecting the renal function in nephrotic syndrome.
Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Creatinine ; Cyclooxygenase 2* ; Cyclooxygenase Inhibitors ; Foot ; Microscopy, Electron ; Nephrotic Syndrome ; Prostaglandins ; Proteinuria ; Puromycin Aminonucleoside* ; Puromycin* ; Rats* ; Rats, Sprague-Dawley