This is study was performed to assess socioeconomic status and physical health status of middle-aged men (40's~60's) in Ganghwa country. We interviewed 1,267 middle-aged men (602 male, 665 female) by trained interviewers using structured questionnaires including demographic information, general health status, and anthropometric measurements. And all the data were analyzed by chi-square test, Student's t-test and one-way ANOVA using SPSS 12.0 version at p<0.05. These results were that males were higher than females in educational levels (p=0.000) and most of them decreased according to age in educational levels (p=0.000) and family income (p=0.000), and prevalence of chronic diseases (p=0.000): stomach-duodenum disease, fracture, arthritis, or hypertension. They took to the health information on TV and radio and their health managing methods were exercise and walking and resting and diet regulation. Body Mass Index (BMI) was decreased in older males (p=0.024) but increased in older females (p=0.001). In females, obesity prevalence of 40's, 50's and 60's was 31.3%, 49.7% and 48.0%, respectively. Waist circumference was the highest in 50's males (p=0.015), but hip circumference was the highest in 50's females (p=0.015). Waist-hip ratio (WHR) increased in older males (p=0.028) and females (p=0.000). In spite of the subjects were engaged in agriculture and fishery and had desirable lifestyles, obesity rate especially abdominal obesity, was the serious problem. Socioeconomic status, especially education and income were related to SRH (p=0.006, p=0.000), chronic disease (p=0.000) and BMI (p=0.028, p=0.000). Therefore, it is necessary that the public health policy and nutrition education programs to alter lifestyles and to improve health preservation and health promotion in the farming and fishing communities.
Adult* ; Agriculture ; Arthritis ; Body Mass Index ; Chronic Disease ; Diet ; Education ; Female ; Fisheries ; Health Promotion ; Hip ; Humans ; Hypertension ; Life Style ; Male ; Obesity ; Obesity, Abdominal ; Prevalence ; Public Health ; Social Class* ; Waist Circumference ; Waist-Hip Ratio ; Walking

The increasingly common use of obstetrical sonography has led to a growing number of prenatally diagnosed neuroblastomas. The two most important factors in the prognosis of clinical neuroblastoma are the age of the patient at diagnosis and the stage of the disease. Patients with disease at an earlier stage and well-differentiated tumors have a better prognosis than those with disease at a more advanced stage and poorly differentiated tumors. We have experienced a case of congenital neuroblastoma that was recognized prenatally by ultrasonography and identified as stage IV disease postnatally. We report the case with brief review of related literatures.
Diagnosis ; Humans ; Neuroblastoma* ; Prenatal Diagnosis ; Prognosis ; Ultrasonography ; Ultrasonography, Prenatal*

BACKGROUND: The purpose of this study was to find out the cause of discrepancy between various automated immunoassays for 25-hydroxy-vitamin D (25-[OH]D). METHODS: National Institute of Standards & Technology Standard Reference Material (SRM) 972a is SRM for 25-(OH)D and consists of 4 vials of frozen serum with different concentrations of 25-(OH)D. Each concentration was measured 6 times in 3 different immunoassays: ADVIA Vitamin D Total assay (Siemens Healthcare, Erlangen, Germany), ARCHITECT 25-(OH)D (Abbott Laboratories, Abbott Park, IL, USA), and COBAS Vitamin D Total assay (Roche Diagnostics, Basel, Switzerland). RESULTS: When using the certified reference values of SRM 972a as it is, discarding the cross-reactivity of each immunoassay, for ADVIA, the coefficient of determination (R2) as a score of regression analysis was 0.8995 and maximal difference between measured value and certified reference value was 3.6 ng/mL in level 3. The R2 and maximal differences of ARCHITECT were 0.5377 and 6.9 ng/mL, respectively, in level 4. Those of COBAS were 0.3674 and 22.3 ng/mL, respectively, in level 4. When considering cross-reactivities of each immunoassays to various 25-(OH)D metabolites, the ADVIA had R2 and maximal difference of 0.9254 and 3.3 ng/mL, respectively, in level 3. For ARCHITECT, the R2 and maximal differences were 0.7602 and 5.1 ng/mL, respectively, in level 1. Those of COBAS were 0.9284 and 4.9 ng/mL, respectively, in level 1. CONCLUSIONS: The cause of discrepancies between vitamin D immunoassays was mainly on the difference in cross-reactivities to various vitamin D metabolites. The discrepancies can be considerably decreased by considering cross-reactivities of each immunoassay.
Cross Reactions ; Delivery of Health Care ; Immunoassay* ; Reference Values ; Vitamin D* ; Vitamins*

BACKGROUND: Infectious vaginitis is a common gynecologic disease that is primarily caused by three pathogens (Trichomonas vaginalis, Gardnerella vaginalis, and Candida species). The aim of this study was to confirm the effects of other infectious vaginitis-related test results on the interpretation of Gram stain and Papanicolaou (Pap) smear test results for disease diagnosis. METHODS: A total of 300 vaginal samples were collected from women presenting symptoms of vaginitis. The presence of the three previously mentioned pathogens was evaluated using both a Gram stain and Pap smear test, and interpreted twice by 4 different observers. The first interpretation was performed without any information, and a second interpretation was performed with knowledge of results of an Affirm VPIII test that was used to diagnose infectious vaginitis. The results from the two interpretations were compared and the sensitivity and specificity of both tests were evaluated. RESULTS: For the Gram stain samples, the detection rates of G. vaginalis were increased in the second interpretation by 6.2%, while the detection rates of Candida spp. were decreased by 0.3%. For the Pap smear test samples, the detection rates of G. vaginalis were increased in the second interpretation by 7.0%, and the detection rates of Candida spp. were increased by 2.0%. The sensitivity of both tests was increased in the second interpretation by 5.5% to 66.7%. There was no difference in the specificity between the two interpretations. CONCLUSIONS: We demonstrated that there is significant inter-observer variation when using Gram stain and Pap smear test results to diagnose infectious vaginitis. The detection rates and sensitivity of both tests changed when the results from an additional test were incorporated into the interpretation. Additional studies are needed to develop objective criteria and a standardized interpretation system for the evaluation of results from these diagnostic tests.
Candida ; Diagnosis* ; Diagnostic Tests, Routine ; Female ; Gardnerella vaginalis ; Genital Diseases, Female ; Humans ; Knowledge of Results (Psychology) ; Observer Variation ; Papanicolaou Test* ; Sensitivity and Specificity ; Vaginitis*

BACKGROUND: Compliance with hand hygiene protocols is one of the simplest ways to prevent healthcare-associated infections (HAIs). Hand hygiene is influenced by individual habits and beliefs, as well as by local organizational culture practices. This study was performed in order to increase the rate of compliance to hand hygiene through changes in the organizational culture. METHODS: From 2009 through 2011, this study was performed in a 2,000-bed tertiary-care university hospital with more than 6,000 employees. The program was implemented mainly by team activities, and the leadership and hand hygiene steering committee members supported them. Goals for planning, intervention, and evaluation of the compliance rate for hand hygiene were made annually in the hospital. RESULTS: The rate of compliance to hand hygiene increased significantly each year (43.8% in 2008, 75.3% in 2009, 80.7% in 2010, and 83.2% in 2011). The detection rate of vancomycin-resistant Enterococcus (VRE) and the incidence of healthcare-associated Staphylococcus aureus bacteremia decreased. CONCLUSION: The rate of compliance to hand hygiene was remarkably improved, and it continuously increased through systematic and continuous changes in the organizational culture. In addition, the detection rate of VRE and incidence of S. aureus bacteremia decreased. These results show that hand hygiene is an important factor for preventing HAIs.
Bacteremia ; Committee Membership ; Compliance ; Enterococcus ; Hand Hygiene ; Incidence ; Organizational Culture ; Staphylococcus aureus

BACKGROUND/AIMS: Portal hypertension in cirrhosis is associated with a hyperdynamic circulation, which is characterized by hypervolemia, high cardiac output, arterial hypotension and low peripheral vascular resistance. These circulatory abnormalities are thought to be secondary to a splanchnic arteriolar vasodilation related to the increase in portal pressure. Studies assessing regional hemodynamics in patients of cirrhosis with ascites have shown vasoconstriction in the renal circulation and in peripheral vascular territory. This study was designed to assess the cerebral vascular resistance in cirrhotic patients with ascites. METHODS: The resistive index in the middle cerebral artery and in a renal interlobar artery were measured by Doppler ultrasonography in 12 cirrhotic subjects without ascites, 23 cirrhotic subjects with ascites, and 8 healthy subjects. The arterial blood pressure and plasma renin and norepinephrine concentration, which reflect the activity of the renin-ngiotensin and sympathetic nervous systems respectively, were also measured. RESULTS: The resistive index in the middle cerebral artery were significantly higher in cirrhotic patients with ascites (0.58 +/- 0.04, mean +/- standard deviation) than in cirrhotic patients without ascites (0.53 +/- 0.02, p<0.01) and in control subjects (0.50 +/- 0.05, p<0.01). The resistive index in the middle cerebral artery showed direct correlation with renal resistive index (r = 0.52, p<0.01), plasma renin activity (r = 0.44, p<0.01) and norepinephrine (r = 0.33, p<0.05). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure (r = -.59, p<0.01). CONCLUSION: The results suggest that in patients of cirrhosis with ascites, independent of the amount of ascites, there is a cerebral vasoconstriction which is related with the arterial hypotension and the overactivity of vasoconstrictor systems.
Arterial Pressure ; Arteries ; Ascites* ; Cardiac Output, High ; Fibrosis ; Hemodynamics ; Humans ; Hypertension, Portal ; Hypotension ; Liver Cirrhosis* ; Liver* ; Middle Cerebral Artery ; Norepinephrine ; Plasma ; Portal Pressure ; Renal Circulation ; Renin ; Sympathetic Nervous System ; Ultrasonography, Doppler ; Vascular Resistance ; Vasoconstriction ; Vasodilation

This study was performed to evaluate the osteogenic effect of allogenic canine umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) mixed with beta-tricalcium phosphate (beta-TCP) in orthotopic implantation. Seven hundred milligrams of beta-TCP mixed with 1 x 10(6) UCB-MSCs diluted with 0.5 ml of saline (group CM) and mixed with the same volume of saline as control (group C) were implanted into a 1.5 cm diaphyseal defect and wrapped with PLGC membrane in the radius of Beagle dogs. Radiographs of the antebrachium were made after surgery. The implants were harvested 12 weeks after implantation and specimens were stained with H&E, toluidine blue and Villanueva-Goldner stains for histological examination and histomorphometric analysis of new bone formation. Additionally, UCB-MSCs were applied to a dog with non-union fracture. Radiographically, continuity between implant and host bone was evident at only one of six interfaces in group C by 12 weeks, but in three of six interfaces in group CM. Radiolucency was found only near the bone end in group C at 12 weeks after implantation, but in the entire graft in group CM. Histologically, bone formation was observed around beta-TCP in longitudinal sections of implant in both groups. Histomorphometric analysis revealed significantly increased new bone formation in group CM at 12 weeks after implantation (p < 0.05). When applied to the non-union fracture, fracture healing was identified by 6 weeks after injection of UCB-MSCs. The present study indicates that a mixture of UCB-MSCs and beta-TCP is a promising osteogenic material for repairing bone defects.
Animals ; Biocompatible Materials/metabolism/therapeutic use ; Bone Substitutes/*therapeutic use ; Calcium Phosphates/*therapeutic use ; Dogs ; Fetal Blood/*cytology ; Fracture Fixation/methods/veterinary ; Mesenchymal Stem Cells/*physiology ; Osteogenesis/*physiology ; Tissue Engineering/methods ; Wound Healing/physiology

PURPOSE: To compare the change in higher-order aberrations (HOAs) in the treatment of myopia between two different Wavefront-guided excimer ablations: laser in situ keratomileusis (LASIK) and laser assisted subepithelial keratomileusis (LASEK). METHODS: One hundred and four eyes of 52 patients were treated with wavefront-guided LASIK while 104 eyes of 54 patients were treated with wavefront-guided LASEK. Pupil size, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), manifest refraction, corneal topography, pachymetry, and wavefront aberrations were examined preoperatively. BCVA, UCVA, manifest refraction, and wavefront aberrations were measured at 1 and 3 months postoperatively. The Hartmann-Shack aberrometer (WaveScan, VISX) was used to measure the overall wavefront aberrations for scotopic pupils. RESULTS: The wavefront error of HOAs did not increase postoperatively in either group compared with preoperative values. Normalized polar Zernike coefficients compared between preoperative and postoperative values showed a statistically significant increase in spherical aberration term in the wavefront-guided LASIK group (p<0.001). Comparing normalized polar Zernike coefficients values between the two groups, the spherical and 2nd coma aberrations at postoperative 1 month in wavefront-guided LASEK were significantly higher than those of the wavefront-guided LASIK group (p=0.002, both). CONCLUSIONS: HOAs did not increase in either wavefront-guided LASIK or wavefront-guided LASEK compared to the previous conventional methods. However, the average RMS wavefront error of the HOAs was lower in the wavefront-guided LASIK group at 1 month postoperatively (p=0.0004).
Coma ; Corneal Topography ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ* ; Myopia ; Pupil ; Visual Acuity

PURPOSE: CT and MR findings of cerebral fat embolism syndrome(CFES) have been rarely reported, because its diagnosis had been made on the basis of only clinical features in the majority of the cases. The purpose of this study is to describe the clinical, CT, and MR findings in six patients of CFES. MATERIALS AND METHODS: Brain CT and MR findings were retrospectively analyzed in six patients with CFES that was diagnosed on the basis of clinical and MRI findings. All six patients had long bone fractures and showed typical delayed clinical manifestations 2-3 days later. Both CT and MRI were examined in all of six patients. Initial CT scan was performed within 48 hours after trauma in all patients, andfollow-up CT scan was done in 2-11 days in two patients. MRI was done within 2-7 days after trauma in three patients, and 13 days, 18 days, and 45 days in other three patients. Follow-up MRI studies were performed in 2-60 weeks in four patients. Clinical and laboratory findings were analyzed retrospectively with medical records. CT and MRI findings were evaluated with regard to presence or absence of diffuse brain swelling and focal abnormalities of signal intensity(density). RESULTS: CT scans obtained within 2 days after trauma showed diffuse cerebral swelling in five patients and normal findng in one patient. On Tl-weighted MRI, diffuse cerebral swelling was shown in three cases and high signal spots suggesting cerebral petechial hemorrhage were noted in both caudate nuclei and thalami in two cases. On T2-weighted images, high signal spots which were shown on Tl-weighted image were not visible. In all of six cases, multiple lesions of high signal were observed mainly in the cerebral white matters, cerebellum and brain stem, probably representing ischemia/infarct or edema. On the follow-up MRI studies performed within a period from weeks to one month after trauma, the size and the number of the lesions were significantly decreased and these findings were well corresponded with clinical course. CONCLUSION: MR findings' of CFES include diffuse cerebral swelling, petechial hemorrhage and mi- croinfarcts, which characteristically improved in short period. In cases suspected of having CFES, MRI is more useful than CT for initial and follow-up studies because of its high detection rate of lesions and correspondence with clinical course.
Brain ; Brain Edema ; Brain Stem ; Cerebellum ; Diagnosis ; Edema ; Embolism, Fat* ; Follow-Up Studies ; Fractures, Bone ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Smoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period. METHODS: Thirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed. RESULTS: After 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59-223.22). CONCLUSION: This study shows that a patient's willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.
Chronic Disease ; Counseling ; Hospitalization ; Humans ; Inpatients* ; Male ; Risk Factors ; Smoke* ; Smoking Cessation* ; Smoking* ; Stroke* ; Telephone ; Tobacco Use Disorder