BACKGROUND: Primary hepatocellular carcinoma(HCC) is the second cause of cancer death in our country. Hepatitis B virus(HBV) and hepatitis C virus(HCV) are important risk factors for hepatocellular carcinoma. The mechanism of HCC development and the epidemiology in HCV infected individuals are still unclear. In this study, we investigated the epidemiolgical and clinical features of HCC in relation to viral infection. METHODS: We reviewed the medical records of 160 HCC patients retrspectively who had been admitted to one University Hospital located in Seoul between January 1991 and December 1995. Among these patients, 113 patients were positive for HBsAg(B group), 24 for anti-HCV(C group). We compared epidemiological and clinical data between B group and C guoup. RESULTS: Anti-HCV positivity was significantly higher in HBsAg negative patients than in HBsAg positive patients(53.3:1.7%, p<0.01). The mean age of patients in B group was significantly lower than that in C group(52:62yr, p<0.01). In C group, the proportion of Child-Pugh class B and C was significantly larger than that of B group(35.4: 75.0%, p<0.01). In C group, the proportion of transfusion history was significantly larger than that in B group(4.4: 16.7%, p<0.05), and the proportion of drug abuse hestory was significantly larger than that in B group (31.0:62.5%, p<0.01). In C group, the albumin, cholesterol, Gamma-glutamyl transferase leves were significantly lower than those in B group. In B group, the proportion of metastasis was significantly larger than that in C group(31.9:4.2%, p<0.01). Alpha fetoprotein levels greater than 400ng/ml are much more prevalent in group B significantly(67:39.1%, p<0.05). No significant differences in cumulative survival rate(1yr, 2yr) and median survival time were observed between the two groups. CONCLUSIONS: We ascertain that the HBV and HCV are inportant factors in HCC. In epidemiology and clinical features of HCC, there were some difference between the HBsAg and anti HCV positive group. Therefore, on primary health care settings, it is necessary to test for hepatitis C as well as hepatitis B in order to prevent and manage HCC and chronic liver desease.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cholesterol ; Epidemiology* ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis C ; Humans ; Liver ; Medical Records ; Neoplasm Metastasis ; Primary Health Care ; Risk Factors ; Seoul ; Substance-Related Disorders ; Transferases

Purpose: This study explored the association between workplace discrimination and violence and depressive symptoms among Korean employees. Methods: Data were obtained from the 4th Korean Working Condition Survey of 2014, which included 21,902 Korean employees. Depressive symptoms were measured using the WHO-5 Well-Being Index questionnaire scales. Results: A statistically significant relationship between workplace discrimination and workplace violence was found, and these two variables were also associated with depressive symptoms. After adjusting for variables such as sociodemographic characteristics, physical risk, and psychosocial working environment, workplace discrimination (OR=1.22, p<.001) and workplace violence (OR=1.69, p<.001) were both significantly associated with depressive symptoms. Conclusion This study indicates that to promote employees’ psychological health, systems and programs to prevent workplace discrimination and violence are needed. Development of these systems and programs should consider employees’ experiences of workplace discrimination and workplace violence, sociodemographic characteristics, physical risk, and psychosocial working environments.

Purpose: This study aimed to identify differences in physical working environments, psychosocial working environments, and health outcomes according to the employment type of delivery workers. Methods: This study was a secondary analysis of data collected from the Fifth Korean Working Conditions Survey (KWCS). Participants were 84 Korean delivery workers. Data were analyzed using the SAS 9.4 Version, x 2 test and Fisher’s exact test. Results: Statistically significant differences were found according to the employment type of delivery workers (special types, wage) including “noise”, “vibrations”, “repetitive movements”, “supervisor support”, “colleague support”, “manuals on emotional expression”, “existence of trade union, works council or similar body”. Conclusion This study suggests the necessity of improving the working environment and health outcomes of delivery workers belonging to special employment types. In developing these, the laws and systems must be reorganized to enable the recognition of delivery workers as wage workers. In addition, delivery companies should be held responsible for managing delivery workers.

With porcine vertebrae, the static and dynamic holding power of the pedicle screws under various conditions were measured to understand the biomechanical nature of the transpedicular screw fixation in spine. The objectives of the present study were; (1) to find the correlation between the insertion depth of the screw and the resulting holding power, (2) to determine the effect of bone cement augmentation on the screw fixation in a loosened hole, and (3) to assess the load-sharing mechanism between the cortical and the cancellous one surrounding the screw in this fixational system. The geomorphological characteristics of each porcine vertebra was measured directly with a micro-caliper. The bone mineral density of the specimens was also measured. Material with screw was holded in the fixed cross head of material testing system(Autograph E-10T). Testing force was applied and graph was obtained in the chart record. The results of the static pull-out tests in this study showed that there was a statistically-significant positive correlation between the screw diameter and the pull-out resistance(p < 0.05). The strength of the fixation did not actually increase as much as the insertion depth of the screw increased in these tests(r=0.457). In low-cycle fatigue tests, the increased number of cycles was required to clinical failure in the deeper-inserted crews. Considering the mechanical failure, a statistically-significant positive correlation between the failure cycle and the insertion depth was observed in both deep and shallow insertion groups(p < 0.05). Nonpressurized PMMA augmentation appeared to restore the ability of the screws to withstand pullout loading of the original value. On the effect of the cortical and cancellous bone, the most important factor was the cortical bone of the entrance near the screw.
Bone Density ; Fatigue ; Head ; In Vitro Techniques ; Pedicle Screws ; Polymethyl Methacrylate ; Spine

Kindling, induced by repeated subconvulsive electrical or chemical stimulations, leads to progressive and permanent amplification of seizure activity, resulting in permanent brain changes. It is a good animal model of epilepsy and neural plasticity. C-fos has been proposed as the gene responsible for turning on molecular events for these permanent brain changes underlying epilepsy and neural plasticity. But the role of c-fos in the development of kindling is controversial. This study was undertaken to investigate the role of c-fos mRNA in the plastic changes underlying kindling. Among 66 adult male Sprague-Dawley rats, 29 rats were kindled by repeated administrations of subconvulsive doses (IS-25 mg/kg) of pentylenetetrazol (PTZ), 25 rats experienced convulsions induced by a single injection of convulsive dose(30-60 mg/kg) of PTZ, and 12 rats experienced convulsions by a single electroconvulsive shock (ECS), Twelve control rats received normal saline only. Animals were sacrificed at various seizure stages. C-fos mRNA levels in the hippocampus were quantified using slot-blot hybridization analysis. In the experiment of PTZ kindling, c-fos mRNA expression 30 min after convulsion was elevated about 2-4 times at stage 1, 2 and 5, but wasn't increased at stage 3 and 4, compared with controls. C-fos mRNA expression 60 min after convulsion was elevated about 2 times at stage 1 and 5, but wasn't increased at stage 2, 3 and 4. In the experiment of PTZ-induced seizures, c-fos mRNA expression 30 min after convulsion was elevated 2.5, 2.2 and 6 times stage 1-2, 3-4, and 5, respectively. C-fos mRNA expression 60 min after convulsion was elevated 3.6 times at stage 3-4, but wasn't increased at stage 2 and 5. In the experiment of ECB-induced seizures, c-fos mRNA expression 1 min after mild convulsion was elevated 3,3 times, but wasn't increased generalized tonic-clonic seizure. C-fos mRNA expression 60 min after convulsion wasn't increased at any stage of convulsion. These results show that c-fos mRNA levels have no meaningful relationship with the stages of PTZ kindling, and PTZ or ECS-induced seizures, and that c-fos mRNA does not seem to play the crucial role in turning on a molecular program underlying kindling.
Adult ; Animals ; Brain ; Electroshock ; Epilepsy ; Hippocampus* ; Humans ; Male ; Models, Animal ; Pentylenetetrazole* ; Plastics ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger* ; Seizures ; Stimulation, Chemical

Among the 85 cases of prosthetic replacement of femoral neck fracture which had been operated at Department of Orthopaedic Surgery, Korea Veterans Hospital from January, 1982 to May, 1990, 32 cases (15 unipolar hemiarthroplasty and 17 bipolar hemiarthroplasty) were examined clinically and radiologically at an average 7.7 years postoperatively. And the results were as follows; 1. The group I (Unipolar hip hemiarthroplasty without cement) had Harris hip score - average 79.4. The group II (Unipolar hip hemiarthroplasty with cement) had Harris hip score average 87.3. The group III (Bipolar hip hemiarthroplasty without cement) had Harris hip score average 80.5. The group IV (Bipolar hip hemiarthroplasty with cement) had Harris hip score average 86. 2. There were 2 cases of stem loosening (13%) among 15 cases in unipolar hip hemiarthroplasty and 1 case (6%) among 17 cases in bipolar hip hemiarthroplasty. 3. The movement of two components in bipolar hip hemiarthroplasty was noted in all cases and the movement of the outer bearing joint was more active than that of the inner. And the movement of the two components was not correlated with the use of cement. But Harris hip score was superior cement stem group to noncement stem group. 4. Unipolar hip hemiarthroplasty showed the similar clinical and radiological results with bipolar hip hemiarthroplasty of femoral neck fracture in the elderly. As a result, unipolar and bipolar hip hemiarthroplasty were considered the proper treatment method of the femoral neck fracture in the elderly.
Aged ; Femoral Neck Fractures ; Femur Neck* ; Hemiarthroplasty* ; Hip* ; Hospitals, Veterans ; Humans ; Joints ; Korea

The impingement syndrome has an anatomical character that occur against the anterior edge and the undersurface of anterior third of the acromion, coracoacromial ligament and acromioclavicular joint. The treatment consists of conservative and surgical things. We consider the surgical intervention only in cases fail to control pain by conservative treatment over 3 months(from Feb. 1990 to Jan. 1994). The author experienced 15 cases (14 pts) in positive impingement sign & test and evaluated by shoulder arthrography in all cases. 1. The mean age was 60 years ranged from 48 to 68 years and the average symptom duration was 23 months. 2. There were all positive impingement sign & test clinically. 3. There were partial tear of rotator cuff in 3 cases and complete tear in 12 cases radiologically. 4. The anterior acromioplasty with division of coracoacromial ligament was performed in all cases, additional rotator cuff repair in 3 cases and bicipital tenodesis in 2 cases. 5. At the follow up based on UCLA shoulder rating scale, results were excellent & good in 13(86%) and unsatisfactory in 2(14%) cases.
Acromioclavicular Joint ; Acromion ; Arthrography ; Decompression, Surgical ; Follow-Up Studies ; Ligaments ; Rotator Cuff ; Shoulder ; Tears ; Tenodesis

In the paget's disease involving the vertebra, the symptom and sign of compression come from encroachment on the spinal cord due to the enlarging vertebral bodies, pedicles and laminae. The cord compression appears to be preceded by a long insidious period of noncharacteristic clinical symptoms with minor neurologic dysfunction. The lumbar syndrome of Paget's disease is classified according to its severity, clinical findings, biochemical factors and radiologic patterns. The severity of neurologic complication in Paget's disease involving the vertebra varies according to the level involved. The outcome depends on the suddeness of symptom onset and the effectiveness of decompression. We have experienced a case of Paget's disease involving long bones and lumbar spine in 56 year old male patient, in which surgical decompression produced improvement. We report a case of spinal stenosis in paget's disease with brief review of literature.
Decompression ; Decompression, Surgical ; Humans ; Male ; Neurologic Manifestations ; Spinal Cord ; Spinal Stenosis ; Spine

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy