Background: Based on the importance of ceasing smoking programs to control the regional disparity of smoking behavior in Korea, this study aims to reveal the variation of smoke rate and determinants of it for 229 provinces. An evaluation of the relative efficiency of the cease smoking program under the consideration of regional characteristics was followed. Methods: The main sources of data are the Korean Statistical Information Service and a national survey on the expenditure of public health centers. Multivariate regression is performed to figure the determinants of regional variation of smoking rate. Based on the result of the regression model, clustering analysis was conducted to group 229 regions by their characteristics. Three clusters were generated. Using data envelopment analysis (DEA), relative efficiency scores are calculated. Results from the pooled model which put 229 provinces in one model to score relative efficiency were compared with the cluster-separated model of each cluster. Results: First, the maximum variation of the smoking rate was 16.9%p. Second, sex ration, the proportion of the elder, and high risk drinking alcohol behavior have a significant role in the regional variation of smoking. Third, the population and proportion of the elder are the main variables for clustering. Fourth, dissimilarity on the results of relative efficiency was found between the pooled model and cluster-separated model, especially for cluster 2. Conclusion This study figured regional variation of smoking rate and its determinants on the regional level. Unconformity of the DEA results between different models implies the issues on regional features when the regional evaluation performed especially on the programs of public health centers.

Purpose: Several studies have associated the serum vitamin D level with total testosterone levels and the prostate volume. Herein, we investigated the effect of vitamin D supplementation on testosterone, prostate, and lower urinary tract symptoms (LUTS) in men. Materials and Methods: Men over 40 years of age diagnosed with a vitamin D deficiency (25[OH]D <20 ng/mL) who received vitamin D supplementation for one year were included in the study and administered 25,000 IU of cholecalciferol every 2 weeks. Prostate ultrasound, uroflowmetry, postvoid residual urine volume measurement, and serological tests (serum testosterone levels, etc.) were performed upon diagnosis and one year later. Participants also answered the International Prostate Symptom Score (IPSS) and Aging Males’ Symptoms Scale (AMS) questionnaires. Results: A significant increase was observed in the vitamin D level following one year of vitamin D supplementation, with a significant decrease in the postvoid residual urine volume, total IPSS score and without a significant change in the prostate volume. Improved psychological subscale score of AMS questionnaire was observed with a statistical significance. Conclusions Vitamin D supplementation suppressed the increase in the prostate volume and improved the LUTS. Although there is no direct effect on serum testosterone levels, vitamin D supplementation helped improve hypogonadal symptoms.

PURPOSE: We investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency. MATERIALS AND METHODS: Eighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels. RESULTS: The subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels. CONCLUSIONS: Serum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.
Abdominal Fat ; Body Composition ; Electric Impedance ; Erectile Dysfunction* ; Exercise ; Exercise Test ; Humans ; Male ; Physical Fitness ; Testosterone*

An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

PURPOSE: Intrarenal location of calculus significantly affects efficacy of SWL. In lower calyceal stone, its antigravitic location has been known to decrease success rate of SWL. In this study, renal calyceal stone is categorized according to its location and especially lower calyceal stone is further divided either with infundibulo-pelvic angle (IPA) greater than 90degreesor that with less than 90degrees. Difference of the treatment results were compared according to the location of stones. MATERIALS AND METHODS: 142 stones(upper calyx: 52, mid calyx: 11, lower calyx: 79) of 117 patients which had been treated by SWL since 1995 were retrospectively studied. The SWL machine used for treatment was EDAP-LT 01 Plus(piezoelectric mechanism with 3.5 MHz ultrasonic imaging system). Complete stone delivery was defined as state with no residual stone on KUB film. RESULTS: The mean stone size was 0.97+/-0.3cm and mean number of treatment session was 5.0+/-3.2. The complete stone delivery rate was 83%. There was no significant difference in number of session according to stone location(upper calyx: 4.4+/-1.9, mid calyx: 3.18+/-1.5, lower calyx: 4.8+/-2.4, p>0.05). The stone sizes of each calyx were 1.1+/-0.33cm, 0.8+/-1.5cm and 0.91+/-0.24 cm respectively. There were no siginificant differences in stone size among calyceal location(p>0.05). The complete stone delivery rate of each calyx were 88.5%(46/52), 90.9%(10/11), 74.7%(59/79) respectivey(p>0.05). Of the 79 lower calyceal stones, of which IPA was greater than 90degreesin 27 stones and less than 90degrees in 52 stones. There was no siginificant difference in size between two groups(0.86+/-0.16cm vs 0.9+/-0.25cm, p>0.05). The stone with greater infundibulo-pelvic angle had more session than that with lesser infundibulo-pelvic angle(4.9+/-2.2 vs 4.3+/-3.3, p=0.039). There was significant difference in complete stone delivery rate according to infundibulo-pelvic angle(96.3% - 26/27 vs 63.4% - 33/52, p=0.034). Also stone with less infundibulo-pelvic angle had inferior stone delivery rate compared with that of upper and mid calyceal stone. CONCLUSIONS: The lower calyceal stones with infundibulo-pelvic angle lesser than 90degreeshad significantly lower stone delivery rate compared with those with greater infundibulo-pelvic angle and upper and mid calyceal stone. In case of lower calyceal stone with infundibulo-pelvic angle less than 90degrees, other treatment such as PNL, pyelolithotomy must be considered as primary treatment modality.
Calculi ; Humans ; Retrospective Studies ; Ultrasonography

PURPOSE: This study was a within subject repeated pretest-posttest design done to compare the effect of disinfection and the degree of MRSA(Methicillin-resistant staphylococcus aureus) isolation from hand disinfectant in ICU nurses. METHOD: Out of the total internal medicine/surgery ICU nurses at a university hospital in Seoul, 29 female nurses who were participating in direct patient care were participants in this study. After collection of samples, Staphylococcus aureus and MRSA were isolated from the palms, nails and nasal cavities of the nurses according to disinfectants (soap and beta-scrub). RESULTS: The effect of disinfection was greater in the beta-scrub group than in the soap group, and the effect of disinfection on palms was higher in the beta-scrub group than in the soap group. As for the degree of MRSA isolation, there was more isolation in palms in the soap group than in the beta-scrub group but there was no difference in the degree of MRSA isolation from the hand disinfectant in nails and nasal cavities. CONCLUSION: Beta-scrub showed a superior prolonged effect against transient bacteria compared with soap. Further, to reduce MRSA infection, we recommend interventions focused on these aspects.
Bacteria ; Disinfectants ; Disinfection* ; Female ; Hand* ; Humans ; Methicillin-Resistant Staphylococcus aureus* ; Nasal Cavity ; Patient Care ; Seoul ; Soaps ; Staphylococcus ; Staphylococcus aureus

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a zoonotic, tick-borne RNA virus of the genus Bandavirus (Family Phenuiviridae), mainly reported in China, Japan, and the Republic of Korea (Korea). For the purpose of this study, a total of 3,898 adult and nymphal ticks of species Haemaphysalis longicornis (94.2%), Haemaphysalis flava (5.0%), Ixodes nipponensis (0.8%), and 1 specimen of Ixodes ovatus, were collected from the Deogyusan National Park, Korea, between April 2016 and June 2018. A single-step reverse transcriptase–nested PCR was performed, targeting the S segment of the SFTSV RNA. Total infection rate (IR) of SFTSV in individual ticks was found to be 6.0%. Based on developmental stages, IR was 5.3% in adults and 6.0% in nymphs. The S segment sequences obtained from PCR were divided into 17 haplotypes. All haplotypes were phylogenetically clustered into clades B-2 and B-3, with 92.7% sequences in B-2 and 7.3% in B-3. These observations indicate that the Korean SFTSV strains were closer to the Japanese than the Chinese strains. Further epidemiological studies are necessary to better understand the characteristics of the Korean SFTSV and its transmission cycle in the ecosystem.

BACKGROUND/OBJECTIVES: Soy isoflavones are structurally similar to estrogen and bind to estrogen receptors, suggesting that they exhibit estrogenic activities; therefore, they are referred to as phytoestrogens. Fermentation may affect the bioavailability of isoflavones altering soy isoflavone glycosides in the form of aglycones. Thus, this study investigated the effects of fermented soybeans by Rhizopus oligosporus on bone metabolism in both young rats as a pilot test and in ovariectomized (ovx) old rats as a model of menopause. MATERIALS/METHODS: In the pilot test, a total of 24 seven-week-old female Sprague-Dawley (SD) rats were fed one of three diets for a period of four weeks: casein, unfermented soybean product, or fermented soybean product by R. oligosporus. In the ovx rat model, 20-week-old SD rats weighing 260-290 g underwent either sham-operation (n = 10) or bilateral ovariectomy (n = 30) and were then fed the AIN-93M diet for one week. Thereafter, rats were fed sham-casein, ovx-casein, ovx-soybean, or ovx-fermented soybean diet for five weeks. After decapitation, femoral bones were isolated and preserved in 9% formalin for assessment of bone mineral density (BMD), bone mineral content (BMC), and bone-breaking strength (BBS). RESULTS: Ovx rats showed significantly increased weight gain and decreased uterine wet weight. Of particular interest, ovx rats fed fermented soybeans showed increased uterine wet weights compared to control rats. Fermented soybean diet caused a significant increase in plasma 17-beta estradiol concentrations in young rats, and 17-beta estradiol levels were enhanced in ovx rats to match those of sham-operated ones. Significantly lower femoral BMD and BMC were observed in ovx rats compared to sham-operated controls, whereas bone areas did not differ statistically among the groups. In addition, BBS tended to be increased in ovx rats fed soybeans and fermented soybeans. CONCLUSIONS: Supplementation of fermented soybeans could have preventive and therapeutic effects against osteoporosis in postmenopausal women.
Animals ; Biological Availability ; Bone Density ; Caseins ; Decapitation ; Diet ; Estradiol ; Estrogens ; Female ; Fermentation ; Formaldehyde ; Glycosides ; Humans ; Isoflavones ; Menopause ; Metabolism ; Models, Animal ; Osteoporosis ; Ovariectomy ; Phytoestrogens ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Receptors, Estrogen ; Rhizopus* ; Soybeans* ; Weight Gain ; Weights and Measures

OBJECTIVE: Endometriosis is a common and enigmatic disease affecting the reproductive life and health of women. Although the retrograde menstruation is a well established model for both transplantation and induction theories, the discrepancy between an incidence of retrograde menstruation and a prevalence for endometriosis suggests the possibility that the development and the progression of endometriosis is associated with individual susceptibility such as altered immune function. An impaired immune response may result in a defect in the ability to remove refluxed menstrual debris, thereby increasing the possibility of endometriosis. We carried out the study to elucidate the immunologic alteration in patients with endometriosis. MATERIALS and METHODS: Fifty-six patients undergoing pelviscopic surgery or open laparotomy for benign gynecological disease were enrolled in this study. The study groups consisted of group I (normal control patients, N=22), group II (endometriosis stage I and II, N 17), and group III (endometriosis stage III and IV, N=17). Lymphocyte subset including total T cell, helper T cell, suppressor T cell, B cell, helper/suppressor ratio, natural killer (NK) cell, monocyte population and cytokine profile including interleukin (lL)-1, soluble interleukin-2 receptor (slL-2R), IL-2, IL-6, IL-S, monocyte chemoattractant protein (MCP)-1 of peripheral blood and peritoneal fluid were analyzed using flow cytometry and enzyme-linked immunosorbant assay (ELISA) method respectively. RESULTS: Peripheral blood and peritoneal fluid lymphocyte subset were indistinguishable among the 3 groups (p>0.05). And there were no significant difference in peripheral blood and peritoneal fluid cytokine profile among the 3 groups except peripheral blood MCP-1 level. Group III showed higher peripheral blood level of MCP-1 than control patients (p<0.05). CONCLUSION: In this study, lymphocyte subset and cytokine profile except MCP-1 in peripheral blood and peritoneal fluid from patients with endometriosis did not differ from those of the control group. Immunologic alterations of patients with endometriosis might be resulted not from the changes of the number of lymphocyte subsets and cytokine, but from the modification of functions.
Ascitic Fluid* ; Endometriosis* ; Female ; Flow Cytometry ; Humans ; Incidence ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Laparotomy ; Lymphocyte Subsets* ; Lymphocytes* ; Menstruation Disturbances ; Monocytes ; Prevalence