BACKGROUND: Current researeh indicates that making among young adults tends to persist into later life. Furthermare, numerous studies have proven the harmful effects of female stmoking on their offspring. These trends have produced a wide variety of(social, medical and economic) problems. This study is aimed at obtaining basic information to help prevent patential smokers from trying their first cigarette as well as to instruct to stop smoking. This study involves the following: a) investigating general factors affecting the smoking status of college students in addition to the deterents to smoking b) seeking to understand the familial influence on smoking status c) resesrching how smokers, ex-smokers and non-smakers perceive their familial influence on their smoking status. METHODS: In June 1998, a self-administered questiannaire was distributed to 800 students of two junior colleges by random sampling in Po'hang. 720 were returned and 642 displayed adequate respanses. The questionnaires were analyzed using SPSS and EXCEL software. RESULTS: Among the tatal of 642 subjects studied, 220 were males(34.3%) and 422 femaks(66.7%). Of the male subjets 149(67%) were smokers, 46(21% ) were ex-smokers and 25(11.3%) were non smokers. Of the female subjcts 22(5.2%) were smokers, 399(92.9%) were ex-smokers and 11(2.6%) were non smokers. The number of cigarettes smoked per day was as follows:79 subjects(46.2%) smoked 10-20 cigarettes, 55(33.2%) smoked less than 10 and 37(21.6%) smoked more than a pack of cigarette. When considering the related factors which affect student smoking it is evident that there is a growing tendency toward smoking among male students when they have dose friends who are smokers and who cansume alcohol on a weekly basis. About the motives of smoking, there was a significant difference between the following two cases. Those(36.2%) who successfully quit smoking had started to smoke through solicitation by friends, but only 2.7% were successful if they had started to smoke to relieve stress When it comes to the influence of familial factors on successful versus unsuccessful attempts to quit smoking, the status of family smokers, whether or not smokers made their habit obvious to family members and whether or not the family allowed smoking did nat have any noticeable statistical difference between continuation of smoking and smoking cessation. However there was an obviaus difference among ex-smokers, non smokers and smokers when they responded as to whether or not their family had an effect on smoking status and smoking cessation:ex-smokers(38.4%), non-smokers(30.6%) and smokers(17.0%). CONCLUSIONS: In the light of the related factors attributed to the continuation of smoking in this study, it was revealed that there was a higher possibility of current smoking when the subject were a male and have close friends who smoked and had a higher level of average alcohol cansumption. this study also indicated that the continued smoking rate was higher among irdividuals who started smoking because of stress than those who began smoking as a result of peer pressure. There was no significant relatianship between smoking status and familial influence on smoking cessation between smokers and ex-smokers, but ex-smokers and non smokers had more awarness of familial influence than smokers.
Female ; Friends ; Humans ; Male ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Products ; Young Adult ; Surveys and Questionnaires

PURPOSE: Total mesorectal excision has been advocated as the effective operation for patients with rectal cancer to reduce the local recurrence rate after curative resection. Its rationale is to remove possible tumor foci at the mesorectum distal to the level of the rectal cancer. This study was undertaken to clarify the rationale for total mesorectal excision. METHODS: Total mesorectal excision was performed in 72 patients with rectal cancer who admitted in Severance Hospital between December, 1996 and December, 1997. The obtained mesorectums were classified to M0 (from the proximal margin to the distal margin of the tumor), M1 (from the distal margin to 2 cm below the distal margin), M2 (from 2 cm to 5 cm below the distal margin), and microscopic examination was done. RESULTS: The nodal metastases were detected in 7 cases and tumor deposits in 4 cases. Especially in M2 with Dukes' C2, the rate of nodal metastases was 3.6 percent and the rate of tumor deposits was 7.1 percent. The nodal metastases and tumor deposits in the distal mesorectum have no correlation with gross finding, size, location and differentiation of the tumor. CONCLUSIONS: En bloc excision of all mesorectal tissue down to at least 5 cm below the lower margin of the tumor is required for patients with advanced rectal cancer to remove possible metastatic lymph nodes and tumor deposits in the distal mesorectum.
Humans ; Lymph Nodes* ; Neoplasm Metastasis* ; Rectal Neoplasms* ; Recurrence

OBJECTIVE: To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. METHODS: One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (DeltaT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. RESULTS: The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal DeltaT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. CONCLUSION: Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.
Electrodiagnosis ; Humans ; Hypothermia ; Incidence ; Lower Extremity ; Magnetic Resonance Imaging ; Muscular Atrophy ; Radiculopathy ; Skin ; Skin Temperature ; Thermography

OBJECTIVE: To analyze the bifurcating points of medial plantar proper digital (MPPD) nerve by using anatomical landmarks on plane coordinates and thus determine the ideal stimulation site for MPPD sensory nerve conduction studies. METHOD: We dissected 10 feet from five adult cadavers and identified the bifurcation points of the MPPD nerve. Two reference lines in relation to anatomical landmarks were defined. A vertical line connecting the mid-point of heel (H) and tip of great toe (G) was defined as the HG line. A transverse line connecting the navicular tuberosity (N) and tuberosity of 5th metatarsal bone (M) was defined as the NM line. The bifurcation points of the 10 MPPD nerves were expressed in X, Y coordinates in relation to these two axis. RESULTS: The bifurcation points were located at approximately 40% (40.0+/-2.4; mean+/-SD) of the HG line from the mid-point of heel (H) and at approximately 37% (36.5+/-3.6) of the NM line from the navicular tuberosity (N). The majority of these points were found to be clustered close to the HG line. CONCLUSION: The data on the MPPD nerve bifurcation points may be useful to localize the appropriate stimulation site that could be used in MPPD nerve conduction studies.
Adult ; Cadaver ; Foot ; Heel ; Humans ; Metatarsal Bones ; Neural Conduction ; Tibial Nerve ; Toes

Purpose: To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods: We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results: In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12–10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38–8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

Purpose: To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods: We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results: In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12–10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38–8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

We report four cases of unilateral pulmonary vein atresia without associated congenital intracardiac anomalies to illustrate a part of the clinical and radiological characteristics and its diagnosis. Pulmonary vein atresia was in right side in all cases. Narrowing of contralateral pulmonary vein and pure red cell anemia were combined in one cases. In four cases, initial presentations were hemoptysis and lower respiratory tract infection. The simple chest X-ray revealed loss of volume, increased reticular interstitial markings of the involved lung and the shift of mediastinal structures to the involved side, and hilar prominency in the contralateral side. Lung perfusion scan revealed no visualization of involved lung. Cardiac Catheterization revealed pulmonary artery hypertension 2/4 and pulmonary artery wedge pressure 1/2. On pulmonary angiogram, nonvisualiaztion of pulmonary vein in the involved side in 3: partial visualization of pulmonary vein not connected to atrium in 1: dysmorphic pulmonary artery on the contralateral side in 1. Right pneumonectomy was done without specific problems in two cases. In conclusion, Unilateral pulmonary vein atresia should be suggested when the clinical and radiological characteristics are present.
Anemia ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Hemoptysis ; Hypertension ; Hypertension, Pulmonary ; Lung ; Perfusion ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Veins* ; Pulmonary Wedge Pressure ; Respiratory Tract Infections ; Thorax

The incidence of lung cancer and its mortality rate are increasing in Korea. At the time of diagnosis, 40% patients of lung cancer patients had metastatic lesions. The common metastatic sites are the contralateral lung, bone, liver, adrenal gland and the brain. Metastasis to oral mucosa is rarely encountered in lung cancer and metastasis to the gingiva is more uncommon. Approximately 1% of malignant carcinomas in the oral cavity are the result of metastases, and 10-25% of metastatic cancers originate from lung cancer. Clinically metastatic gingival lesions are benign including hemangioma, pyogenic granuloma, giant-cell granuloma or a peripheral fibroma. Often metastases to the gingiva are diagnosed too late and by the time they are detected, they have metastases to other organs. Here we report a case of small cell lung carcinoma that had metastased to the gingiva with review of relevant literature.
Adrenal Glands ; Brain ; Diagnosis ; Fibroma ; Gingiva* ; Granuloma ; Granuloma, Pyogenic ; Hemangioma ; Humans ; Incidence ; Korea ; Liver ; Lung ; Lung Neoplasms ; Mortality ; Mouth ; Mouth Mucosa ; Neoplasm Metastasis* ; Small Cell Lung Carcinoma*

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an inflammatory dermatosis associated with systemic immune-mediated diseases such as rheumatoid arthritis, systemic sclerosis, lupus erythematosus, and ulcerative colitis. Histologically, serial development of leukocytoclastic vasculitis is shown from an early stage, which can progress to palisading granuloma in the fully developed stage and to fibrosis in the final stage. A 32-yearold man presented with ankylosing spondylitis showing multiple erythematous papules on his fingers, elbows, knees, and left auricle. Histologic examination from his skin lesion revealed a perforating palisading granuloma with leukocytoclastic vasculitis, which was consistent with PNGD. Therefore, this study reported a case of PNGD accompanied by ankylosing spondylitis as an initial presentation.

BACKGROUND: This study evaluated the effects of remifentanil on hemodynamic changes in endotracheal intubation during rapid sequence induction using thiopental or propofol and succinylcholine. METHODS: One hundred and twenty patients were divided into 4 groups (30 patients in each group).Anesthesia was induced with propofol 2 mg/kg or thiopental 5 mg/kg and succinylcholine 1 mg/kg followed by remifetanil 0.5microgram/kg (group PR), remifentanil 1microgram/kg (group TR) or normal saline as control (group PC, group TC).An endotracheal intubation was performed 90 s later, and vecuronium 0.08 mg/kg was given for neuromuscular block.Anesthesia was maintained using 1-3 vol% enflurane with 2 L/min N2O and 2 L/min O2.Arterial blood pressure (ABP) and heart rate (HR) were recorded before induction, just before intubation, and at 1 min intervals for 5 min after intubation.The incidence of hypertension, hypotension, tachycardia, and bradycardia were recorded. RESULTS: ABP in group PR was lower than in group TR, but HR was not different.The incidence of hypotension in group PR was higher than group TR or group PC.ABP in groups using remifentanil was lower than in control groups.The incidence of hypertension and tachycardia in groups using remifentanil were lower than control groups. CONCLUSIONS: During administration of propofol or thiopental and succinylcholine, remifentanil as a bolus for rapid sequence induction attenuated cardiovascular responses to endotracheal intubation effectively, but with a higher incidence of hypotension following propofol.
Blood Pressure ; Bradycardia ; Enflurane ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Incidence ; Intubation ; Intubation, Intratracheal ; Piperidines ; Propofol ; Succinylcholine ; Tachycardia ; Thiopental ; Vecuronium Bromide