BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving the motor neuron of the cerebrum, brain stem, and spinal cord. It has been suggested that various occupational or environmental agents could be a cause of ALS. We report upon a case of a person contracting ALS who experienced a long-time exposure to pesticides, implying that pesticides are probable causal agents of ALS. CASE REPORTS: The patient has been experiencing shoulder pain and limitation of movement that started abruptly about three years ago. Over time, these symptoms have become aggravated despite ongoing therapies including medication. After two years, he was diagnosed with ALS through electromyography, nerve conduction velocity and many laboratory tests at a university hospital in Seoul. His social and medical history was non-specific. The patient had worked for about 15 years at a waste disposal site and mainly destroyed glass bottles containing pesticides. During this period, his respiratory tract and skin were exposed to various raw pesticides without appropriate personal protective equipment. He did this job one or two times a week and worked for two or more hours without a break. Through an investigation into the patient's working environment, significant levels of dichlorvos, one of the organophosphates, were detected. CONCLUSIONS: The study results revealed that the patient was exposed to considerable doses of pesticides as opposed to men spraying pesticides. Although controversial, pesticide exposures have been associated with ALS. However, we suggest that in this case the possibility that these pesticide exposures acted as a causal agent for the diagnosed ALS based on plausible biological mechanisms and epidemiologic data.
Amyotrophic Lateral Sclerosis ; Brain Stem ; Cerebrum ; Contracts ; Dichlorvos ; Electromyography ; Glass ; Humans ; Male ; Motor Neurons ; Neural Conduction ; Neurodegenerative Diseases ; Occupational Exposure ; Organophosphates ; Pesticides ; Respiratory System ; Shoulder Pain ; Skin ; Spinal Cord

OBJECTIVE: As the accelerated development and use of Electronic Health Record have grown exponentially, the possible disclosure of patient healthcare information is increased. The purpose of this study is to examine the perception gap on disclosure of EHR information among the patient/guardian group, healthcare provider group, and administration group. METHODS: A questionnaire survey from a hospital located in Incheon City of Korea was conducted and over 200 responses were collected. Outcome measures include healthcare information protection, disclosure of unidentifiable information, possible losses from the disclosure of healthcare information, and the ownership of healthcare information. RESULTS: Regarding healthcare information protection, three groups have a general consensus over some issues. In contrast, the healthcare providers and the administration group have a higher consideration regarding possible losses resulting from the disclosure of healthcare information than the patient group. In addition, the healthcare provider group considered the ownership of healthcare information to belong to the hospital in contrast with the patients' view that the ownership and disclosure rights belong to the patient. CONCLUSION: These findings indicate that the high level of interest and concern that our results revealed, suggests that more attention should be directed toward designing and developing policy, organization and legislative systems.
Computer Security ; Consensus ; Delivery of Health Care* ; Disclosure ; Electronic Health Records* ; Health Personnel* ; Human Rights ; Humans ; Incheon ; Korea ; Outcome Assessment (Health Care) ; Ownership ; Privacy* ; Surveys and Questionnaires

Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81.8% of the procedures were effective and 81.5% of patients were satisfied. Only one minor transient complication occurred after an intradiscal procedure but none resulted in death or permanent disability. Thus, safe and effective IPPs can be provided as part of IPS in a local neurosurgical pain centre to bring more comprehensive and less fragmented care for chronic pain patients.

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

OBJECTIVES: To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti- accination community members on the internet. METHODS: An online survey of 245 parents from three pro-vaccination communities and 92 parents from one antivaccination community was conducted from June 7 to June 23, 2006. RESULTS: Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. CONCLUSIONS: On-line communities concerned with vaccination are getting popular. The influence of antivaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.
Adult ; Child, Preschool ; Female ; Health Education/*methods ; *Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Infant ; Internet/*utilization ; Male ; Parents ; Socioeconomic Factors ; *Vaccination

Introduction: Lin-11, Isl-1 and Mec-3 domains (LIM) homeobox genes are among the most important sub-families of homeobox genes. These genes are thought to play an important role in cancer. In this study, the protein expression of these genes was examined in urothelial carcinoma of the bladder. The expression pattern of Islet-1 (ISL1) and LIM homeobox 5 (LHX5) across different cancer stages and grades, as well as the association between the protein expression of these genes and patient demographics and clinicopathological features, were examined. Methods: A total of 100 formalin-fixed paraffin-embedded urothelial carcinoma tissues were selected from the Department of Pathology, Hospital Kuala Lumpur and the protein expression of ISL1 and LHX5 was determined using immunohistochemistry. Results: Positive expression of ISL1 and LHX5 was detected in 94% and 98% of the samples, respectively. There were no distinct LHX5 expression patterns associated with different cancer stages, but the proportion of high-expressing tumours was higher in high-grade tumours. In addition, there was a significant association between the expression of LHX5 and tumour grade. The proportion of tumours expressing high levels of ISL1 was found to be highest in later stage tumours. Conclusion: The high percentage of tumours expressing both these genes suggests that ISL1 and LHX5 play an important role in bladder tumourigenesis across multiple stages.

This study was undertaken to evaluate the effects of health education and anti-Clonorchis campaign conducted in Kyungpook Province and to compare the prevalence of Clonorchis sinensis among the residents in the same areas for the period 1964-1976. Both surveys were made on all age groups of residents ranging from 0 to over 60 years of age. They were examined using primarily intradermal tests with Clonorchis and Paragonimus antigens and followed by stool examinations. The definitive diagnosis of clonorchiasis was made on the recovery of Clonorchis eggs from the stools. A marked reduction in the prevalence was encountered in the youngest age group, but there is no significant difference in the older age groups. The overall prevalence rate for clonorchiasis was reduced from 27.7 to 19.6 per cent in a period of 10 years. It is found that clonorchiasis is less prevalent in Kyungpook Province than it was a decade ago and it continued to decline.
parasitology-helminth-trematoda ; Clonorchis sinensis-clonorchiasis ; Paragonimus westermani ; epidemiology

OBJECTIVES: This study aims to find differences that reflect the magnitude of health disparities in wage workers in Korea according to income index(personal income, household income, equivalized income) by gender. METHODS: Data was obtained from the 11th wave of Korean Labor and Income Panel Survey in 2008. This study analyzed 4,205 subjects(2,570 males and 1,635 females) aged 19-65 years. To compare the health effects of each income index by gender, unconditional multiple logistic regression, health-related behaviors, and working conditions were used. The unconditional multiple logistic regression was adjusted by socio-demographic characteristics. All statistics were estimated using SAS survey procedures. RESULTS: According to unconditional multiple logistic regression, significant differences in ORs between men and women were observed in this study for those wage workers who self-rated their health status to be poor. This was consistent between each income index. Men had an OR of 1.76 (95% CI, 1.28~2.43) by personal income, 1.70 (95%CI, 1.25~2.32) by household income and 1.69 (95% CI, 1.23~2.31) by equivalized income. Women had an 2.09 (95% CI, 1.47~2.97) by household income and OR of 1.95 (95% CI, 1.36~2.79) by equivalized income, but personal income did not have a significant effect on OR for women. CONCLUSIONS: The study of occupational and environmental medicine should consider that each income index has different effects on the self-rated health status according to gender. Household income index and equivalized income index would represent a health status for women.
Aged ; Electrolytes ; Environmental Medicine ; Family Characteristics ; Female ; Humans ; Korea ; Logistic Models ; Male ; Phenothiazines ; Salaries and Fringe Benefits ; Socioeconomic Factors

Urothelial carcinoma is a common malignant neoplasm that has a poor prognosis and a high frequencyof recurrence and metastasis. Constant disease surveillance with periodic and long term cystoscopyexamination is necessary for management of the disease. However, the monitoring and therapyregimen is expensive, incurring a massive burden to patients and the government. Therefore, thedevelopment of specific biomarkers for urothelial carcinoma at an early stage and recurrence detectionbecomes a priority. Homeobox genes are a family of genes that are involved in tumourigenesis.They might be potential prognostic markers for urothelial carcinoma. The study investigated theexpression pattern of NANOG which is one of a homeobox gene in different stages and grades ofurothelial carcinoma. NANOG expressions were also correlated with patient demographic factors andclinicopathological parameters. The expression of NANOG in 100 formalin-fixed paraffin-embeddedurothelial carcinoma tissues was determined by immunohistochemistry. Immunohistochemistryshowed positive expression of NANOG in all specimens with detection in the cytoplasm, nucleiand the nuclear membrane of the cancer cells. The immunohistochemical expression of NANOGincreased across stages and grades of the tumour. The expression of NANOG was not significantlyassociated with demographic factors; gender (p = 0.376), race (p = 0.718) and age (p = 0.058) aswell as with most of the clinicopathological parameters; pathological stage (p = 0.144), grade (p =0.625), lymph node involvement (p = 0.174) and distant metastasis (p = 0.228). However, NANOGexpression showed significant correlation with tumour invasion (p = 0.019). We concluded thatNANOG might be a potential biomarker for early diagnosis of urothelial carcinoma of the bladder.

Matrix metallopeptidase 3 or MMP3, is a zinc-dependent proteolytic enzyme that is involved in various physiological processes via modification of the extracellular matrix. In particular, its over-expression has been associated with cancer metastasis and tumor growth in various cancers including breast cancer. MMP3 gene expression is regulated by several factors such as DNA polymorphisms which also serve as risk factors for breast cancer. As such, DNA polymorphisms of MMP3 have the potential to be utilized as genetic biomarkers for prediction and prognosis of metastatic breast cancer. Presently, genome-wide association studies of MMP3 gene polymorphisms which are associated with breast cancer risk and patient survival in a variety of populations are reviewed. In order to understand the potential role of MMP3 polymorphisms as genetic markers for breast cancer metastasis, the domain structure of MMP3, the regulation of its expression and its role in breast cancer metastasis are also briefly discussed in this review. The emergence of MMP3 gene polymorphisms as prognostic biomarker candidates for breast cancer metastasis may contribute towards improving targeted therapies and categorization of breast cancer cases in order to provide a better and more accurate prognosis.