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*

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

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

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.

Takju is a Korean alcoholic beverage made from rice, and is brewed with the yeast Saccharomyces cerevisiae. This study was conducted to evaluate the effects of exercise training and moderate Takju consumption on learning ability in 6-week old Sprague-Dawley male rats. The rats were treated with exercise and alcohol for 4 weeks in six separate groups as follows: non-exercised control (CC), exercised control (EC), non-exercised consuming ethanol (CA), exercised consuming ethanol (EA), non-exercised consuming Takju (CT), and exercised consuming Takju (ET). An AIN-93M diet was provided ad libitum. Exercise training was performed at a speed of 10 m/min for 15 minutes per day. Ethanol and Takju were administered daily for 6-7 hours to achieve an intake of about 10 ml after 12 hours of deprivation, and, thereafter, the animals were allowed free access to deionized water. A Y-shaped water maze was used from the third week to understand the effects of exercise and alcohol consumption on learning and memory. After sacrifice, brain acetylcholinesterase (AChE) activity was analyzed. Total caloric intake and body weight changes during the experiment were not significantly different among the groups. AChE activity was not significantly different among the groups. The number of errors for position reversal training in the maze was significantly smaller in the EA group than that in the CA and ET groups, and latency times were shorter in the EA group than those in the CC, EC, CT, and ET groups. The latency difference from the first to the fifth day was shortest in the ET group. The exercised groups showed more errors and latency than those of the non-exercised groups on the first day, but the data became equivalent from the second day. The results indicate that moderate exercise can increase memory and learning and that the combination of exercise and Takju ingestion may enhance learning ability.
Acetylcholinesterase ; Alcohol Drinking ; Alcoholic Beverages ; Animals ; Body Weight Changes ; Brain ; Diet ; Eating ; Energy Intake ; Ethanol ; Humans ; Learning ; Male ; Maze Learning ; Memory ; Rats ; Saccharomyces cerevisiae ; Yeasts

A variety of diseases involve the esophagus including esophagitis, benign or malignant tumors, varices, and esophageal perforation. We reviewed the thoracic CT of these various esophageal diseases, and classified them by similar CT findings. The CT findings were circumferential wall thickening, nodular wall thickening, abnormal luminal dilatation, fistula formation, and mass or mass like lesion. Although CT alone has limited diagnostic ability in esophageal disease, it may have an important role in diagnosing submucosal dissection, fistula, perforation, and intramural abscess.
Abscess ; Dilatation ; Esophageal Diseases ; Esophageal Perforation ; Esophagitis ; Esophagus ; Fistula ; Phenobarbital ; Varicose Veins