BACKGROUND: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that relate to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension. METHODS: The subject population was 689 cases from May 1997 to June 1997 in a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to the telephone survey on change of health beliefs, health-related attitudes and compliance. RESULTS: In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group, and 135cases(26.0%) were low compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensives, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01). CONCLUSIONS: Health examination service includirg advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.
Antihypertensive Agents ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Compliance ; Diet ; Drinking ; Dyslipidemias ; Early Diagnosis ; Education ; Health Education ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Hypolipidemic Agents ; Male ; Overweight ; Pamphlets ; Personal Satisfaction ; Prospective Studies ; Smoke ; Smoking ; Telephone ; Surveys and Questionnaires

No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

No abstract available.
Antibodies, Monoclonal* ; Borrelia burgdorferi* ; Borrelia* ; Lyme Disease*

The retrograde microorganismal colonization in the pharynx from stomach may cause the nosocomial pneumonia and that may be more likely when the gastric pH is relatively high. We tried to find out the relationships between the gastric pH and the incidence of nosocomial pneumonia with twenty patients intubated for longer than 48 hours at ICU. We achieved following results: 1) The incidence of the nosocomial pneumonia was twenty percent. 2) All the patients developed nosocomial pneumonia showed the gastric pH above 4.0. 3) In the patients intubated for longer than 5 days, the incidence of nosocomial pneumonia was 33.3% in contrast to 9.0% for less than 5 days. 4) With the sputum culture, the incidence of colonization was higher in the patients with gastric pH above 4.0 than that in the patients with gastric pH below 4.0(84.6% vs 58.1%). 5) With regard to the duration of intubation, the incidence of colonization was higher in the patients intubated for longer than 4 days than that in the patients intubated for less than 4 days(90% vs 50%). 6) The most common pathognomic organisms were astreptoccus and Pseudomonas aeroginosa. It is conculded that the nosocmial pneumonia might develop more frequently in the patients with gastric pH above 4.0 than in the patients with gastric pH below establishment of the relationship between the treatment of the stress ulcer and the nosocomial pneumonia.
Colon ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Intubation ; Pharynx ; Pneumonia* ; Pseudomonas ; Sputum ; Stomach ; Ulcer

BACKGROUND: Basic Fibroblast Growth Factor (bFGF) is known to be closely related to myelofibrosis and hematopoiesis including magakaryopoiesis. The main bone marrow finding in patients with idiopathic thrombocytopenic purpura (ITP) is an increased megakaryopoiesis without myelofibrosis. Purposes of this study are to evaluate the changes in bFGF expression pattern in the bone marrow of patients with ITP and to correlate them with the plasma concentrations of bFGF. METHODS: Paraffin-sections of bone marrow biopsies from 17 cases ITP and 7 cases normal controls, without pathological alterations, were investigated by immunohistochemistry for bFGF and CD68. The plasma levels of bFGF were evaluated by enzyme immunoassay in 7 cases of ITP and controls. RESULTS: The bFGF was strongly expressed in stromal cells and weakly in megakaryocytes in normal controls. The density of the bFGF-expressing stromal cells was decreased in 70% (12/17) of the patients with ITP, compared with none in the other controls. The number of stromal cells in patients with ITP was similar to those in the control groups. The bFGF plasma levels were significantly lower in almost all the ITP patients compared to the control group. CONCLUSIONS: The results indicate that concentrations of bFGF in plasma and bone marrow stromal cells of ITP were decreased. Although the mechanism of low cellular and plasma concentrations of bFGF needs to be elucidated, these findings may complement the serologic and morphological diagnosis of ITP.
Biopsy ; Bone Marrow* ; Complement System Proteins ; Diagnosis ; Fibroblast Growth Factor 2* ; Hematopoiesis ; Humans ; Immunoenzyme Techniques ; Immunohistochemistry ; Megakaryocytes ; Mesenchymal Stromal Cells ; Plasma* ; Primary Myelofibrosis ; Purpura, Thrombocytopenic, Idiopathic* ; Stromal Cells

PURPOSE: CYP2D6 and N-acetyltransferase (NAT2) are polymorphic enzymes which are expressed in the hepatocyte in a genotype-determined manner. They are known to be involved in the inactivation and activation of various mutagens and carcinogens, respectively. The activities of the two enzyme systems are associated with the genetic susceptibility of many human cancers. METHODS: This study was performed to determine the genotype frequencies of the two enzyme systems in primary hepatocellular carcinoma patients and healthy controls. One hundred healthy controls and 55 liver cancer patients were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: In the healthy controls, the CYP2D6 wild type allele frequency was 0.985 and the CYP2D6*4 frequency was 0.015. No CYP2D6 poor-metabolizer was detected. No significant differences were found in the hepatocellular carcinoma patients group. Among the controls, the frequencies of F, S1, S2 and S3 alleles of the NAT2 system were 0.725, 0.01, 0.14 and 0.125, respectively. The genotype frequencies were found to be 0.91 for the rapid acetylator and 0.09 for the slow acetylator. No significant differences were found in the hepatocellular carcinoma group. CONCLUSION: The distribution of CYP2D6 and NAT2 polymorphism is very unique in the Korean population, as characterized by the extremely low frequency of CYP2D6 poor-metabolizer and NAT2 slow acetylator. CYP2D6 and NAT2 polymorphisms did not seem to play an important role in the hepatic carcinogenesis in the Korean population.
Alleles ; Carcinogenesis ; Carcinogens ; Carcinoma, Hepatocellular* ; Cytochrome P-450 CYP2D6* ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Hepatitis B ; Hepatocytes ; Humans ; Korea* ; Liver Neoplasms ; Mutagens

PURPOSE: Nasal cytology for eosinophils has been reported to be very useful for the diagnosis of allergic rhinitis. The purpose of this study is to describe the relationship of the appearance of nasal eosinophils with the levels of total eosinophil counts, total IgE, and house dust mite specific IgE in child patients with symptoms of rhinitis. METHODS: Two hundred seventy eight children with symptoms of rhinitis less than 16 years of age were recruited and evaluated for the following variables: total eosinophil counts, total IgE concentrations, house dust mite specific IgE concentrations, and nasal cytology for eosinophils. RESULTS: The rate of appearance of nasal eosinophils graded as positive rose as the children's age increased. The levels of total eosinophil counts, total IgE concentrations and house dust mite-specific IgE concentrations were significantly higher in children with nasal eosinophils graded as positive than those with less than 5 percent of nasal eosinophils. The rates of appearance of nasal eosinophils graded as positive below and above 250/microL of total eosinophil counts, 250 kUa/L of total IgE concentrations, and 2 kUa/L of house dust mite (D. pteronyssinus or D. farinae) specific IgE concentrations were 16 and 41 percent, 27 and 56 percent, and 13 and 68 percent, respectively CONCLUSION: The levels of total eosinophil counts, total IgE concentrations, and house dust mite specific IgE concentrations correlate significantly with the recovery of nasal eosinophils in children with symptoms of rhinitis.
Child* ; Diagnosis ; Dust* ; Eosinophils* ; Humans ; Immunoglobulin E* ; Pyroglyphidae* ; Rhinitis*

Epidermoid cyst is a common skin lesion. However, in areas where the skin is tightly adherent to the bone, a portion of the epidermis may be implanted into the bone traumatically or a subcutaneous epidermoid cyst may penetrate the bone cortex. Intraosseous epidermoid cyst is rare, and arises almost exclusively in the skull and phalanges of the hand. In the hands, terminal phalanx is involved in almost all cases. Differential diagnosis includes glomus tumor with bone erosion, enchondroma, osteomyelitis, aneurysmal bone cyst and metastatic tumors. We experienced a case of intraosseous epidermoid cyst in the distal phalanx of a 28-year-old woman, who had injured her finger about 20 years ago. We report the clinical, radiographic and pathological findings in detail.
Adult ; Aneurysm ; Bone Cysts ; Chondroma ; Diagnosis, Differential ; Epidermal Cyst* ; Epidermis ; Female ; Fingers ; Glomus Tumor ; Hand ; Humans ; Osteomyelitis ; Skin ; Skull

Here, we report a rare case of L3 chordoma progressed to an intradural extramedullary (IDEM) mass and distant metastasis to the fascia lata. A 64-year old female patient presented to a local university hospital due to back pain and received excisional biopsy for a L3 destructive bony lesion. Local radiation therapy was initially administered, assuming a malignancy of unknown origin, but she developed cerebrospinal fluid leakage during adjuvant radiation therapy, which was managed by wound revision and lumbar drainage. As the destructive lesion progressed, she visited our hospital for a second opinion 3 months after the biopsy. After review of outside pathology, we diagnosed the lesion to be a chordoma, and performed a L3 corpectomy with cage and plate fixation. One and a half years later, positron emission tomography and computed tomography (PET-CT) revealed a right tensor fascia lata hypermetabolic lesion. Excisional biopsy confirmed a distant metastasis of the chordoma. One year later, she complained of L2 radiating pain. PET-CT and CT myelogram revealed an IDEM lesion. Surgical excision confirmed the transdural invasion of the chordoma. To our knowledge, this is the first report of an iatrogenic IDEM invasion and distant metastasis to the tensor of the fascia lata by a L3 chordoma.

BACKGROUND: Measurement of the plasma adrenocorticotropic hormone (ACTH) level has been recommended as the first diagnostic test for differentiating between ACTH-independent Cushing syndrome (CS) and ACTH-dependent CS. When plasma ACTH values are inconclusive, a differential diagnosis of CS can be made based upon measurement of the serum dehydroepiandrosterone sulfate (DHEA-S) level and results of the high-dose dexamethasone suppression test (HDST). The aim of this study was to assess the utility of plasma ACTH to differentiate adrenal CS from Cushing' disease (CD) and compare it with that of the HDST results and serum DHEA-S level. METHODS: We performed a retrospective, multicenter study from January 2000 to May 2012 involving 92 patients with endogenous CS. The levels of plasma ACTH, serum cortisol, 24-hour urine free cortisol (UFC) after the HDST, and serum DHEA-S were measured. RESULTS: Fifty-seven patients had adrenal CS and 35 patients had CD. The area under the curve of plasma ACTH, serum DHEA-S, percentage suppression of serum cortisol, and UFC after HDST were 0.954, 0.841, 0.950, and 0.997, respectively (all P<0.001). The cut-off values for plasma ACTH, percentage suppression of serum cortisol, and UFC after HDST were 5.3 pmol/L, 33.3%, and 61.6%, respectively. The sensitivity and specificity of plasma ACTH measurement were 84.2% and 94.3%, those of serum cortisol were 95.8% and 90.6%, and those of UFC after the HDST were 97.9% and 96.7%, respectively. CONCLUSION: Significant overlap in plasma ACTH levels was seen between patients with adrenal CS and those with CD. The HDST may be useful in differentiating between these forms of the disease, especially when the plasma ACTH level alone is not conclusive.
Adrenocorticotropic Hormone* ; Cushing Syndrome* ; Dehydroepiandrosterone Sulfate ; Dexamethasone ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Humans ; Hydrocortisone ; Pituitary ACTH Hypersecretion* ; Plasma* ; Retrospective Studies ; Sensitivity and Specificity