We report a case of glomerular disease with both mesangial IgA and subepithelial IgG deposits in the allograft kidney. The patient was a 36 year-old man who had received a renal allograft 1 year previously. Fifteen days before admission, he discovered a microscopic hematuria without clinical evidences of allograft rejection. Light microscopy showed diffuse increase of mesangial matrix without mesangial cell proliferation. Capillary walls were diffusely and mildly thickened. Immunofluorescence microscopy demonstrated both granular deposits of IgA in the mesangium and IgG along the capillary walls. On electron microscopy, electron-dense deposits were identified not only in the mesangium but also on the epithelial side of the glomerular basement membrane.
Adult ; Case Report ; Glomerulonephritis, IGA/*immunology/pathology ; Human ; Immunoglobulin A/*analysis ; Immunoglobulin G/analysis ; Kidney/*immunology/pathology ; Kidney Transplantation/*immunology ; Male ; Transplantation, Homologous

Purpose: Smoking is a way of coping with anxiety and stress. This study aimed to identify the effects of forest-thermal combined therapy on anxiety and depression in smokers who desire to quit smoking. Methods: Thirty participants were included in the study, 15 in the experimental group and 15 in the control group. Those in the experimental group participated in a three-day forest-thermal combined therapy program. The program includes forest walks, meditation and thermal therapy in the charcoal kiln. Results: Before and after the program, physiological indicators such as cortisol, heart rate variability, and serotonin anxiety level using the state-trait anxiety inventory (STAI), and stress level using the psychosocial well-being index (PWI) were measured in both groups. The differences in STAI (p = .012) and PWI (p = .006) scores between the experimental and control groups were statistically significant. However, cortisol, heart rate variability, and serotonin were not significantly different between the two groups after the program. Conclusion These results show that forest-thermal combination therapy effectively reduces anxiety and stress in smokers. It suggests that forest-thermal therapy can potentially increase smoking cessation rates.

Generally, larger sample size leads to a greater statistical power to detect a significant difference. We may increase the sample size for both case and control in order to obtain greater power. However, it is often the case that increasing sample size for case is not feasible for a variety of reasons. In order to look at change in power as the ratio of control to case varies (1:1 to 4:1), we conduct association tests with simulated data generated by PLINK. The simulated data consist of 50 disease SNPs and 300 non-disease SNPs and we compute powers for disease SNPs. Genetic Power Calculator was used for computing powers with varying the ratio of control to case (1:1, 2:1, 3:1, 4:1). In this study, we show that gains in statistical power resulting from increasing the ratio of control to case are substantial for the simulated data. Similar results might be expected for real data.
Case-Control Studies ; Polymorphism, Single Nucleotide ; Sample Size

OBJECTIVES: The objectives of this study were to examine the difference in attitude toward health-specific locus-of-control and medical care among western medical students, oriental medical students, and non-medical school students. METHODS: The subjects of this study were 667 students who agreed to respond the questionnaire : 212 western medical school students, 190 oriental medical school students, and 265 non-medical school students. The health-specific locus of control was measured by the structured questionnaire developed by Lau and Ware. The attitude toward western and oriental medicine was also measured by the questionnaire. RESULTS: Western medical students and non-medical school students were more likely than oriental medical students to place high value on 'the provider control over health' and 'the general threat to health' scales (F=20.47, F=19.98). But oriental medical school students ranked 'the self control of health' scale as more important than any other locus of control scale (F=19.34). The health specific locus of control was also different from the grade. When the grade was increased, 'the provider control over health' scale was slowly decreased, especially in western medical students and non medical school students. However, the 'general threat to health' scale was increased in oriental medical students. Western medical school students expressed more positive attitude toward western medicine. Oriental medical school students put a higher score on oriental medicine. Nevertheless, as the grade was increased, the positive attitude toward oriental medicine slightly decreased in oriental medical school students. CONCLUSIONS: There is a difference in health-specific locus of control and attitude toward medicine among western medical students, oriental medical students, and non-medical students. The locus of control and attitude of medical students towards medicine may affect both how they behave towards patients and how they help shape future public policy. Therefore, interdisciplinary educational initiatives may be the best way to handle this issue.
Complementary Therapies ; Humans ; Internal-External Control ; Medicine, East Asian Traditional ; Public Policy ; Schools, Medical* ; Self-Control ; Students, Medical ; Weights and Measures

The purpose of this study was to investigate food sanitation status in elderly welfare facilities and assess the performance of food sanitation practices. Twenty elderly welfare facilities out of 85 located in Seoul with a capacity of fewer than 50 persons participated. The food sanitation status of worktable, kitchen utensils (knives, cutting boards, ladles, spoons), and tableware and bowls were examined by ATP bioluminescence. The results found that the ATP value of knife was the highest. Those of ladles appeared relatively higher than others. Meanwhile, the tableware and bowls, although washed everyday after meals, had the lowest ATP value. This study also conducted a survey on the food sanitation practices of 32 cooking employees in the 20 facilities. Fifty-six percent were in their 40s, and 53% had graduated from high school. More than half (66%) of them had no certification of cooking. Half of the respondents had worked for at least 5 years in food service facilities, and had received food sanitation training. Among them, 31% said they applied food sanitation training while working, and 47% responded the training was very helpful. The foodservice employees demonstrated good food sanitation practices. The results show that food sanitation performance of the workers significantly differed according to their age, education level, total work experience in food service facilities, chef certification, and prior food sanitation experience.
Adenosine Triphosphate ; Aged ; Certification ; Cooking ; Surveys and Questionnaires ; Food Services ; Humans ; Meals ; Sanitation

PURPOSE: The aim of this study was to investigate the impact of accidental events, depression, and anxiety among workers with industrial accidents in South Korea. METHODS: The participants were 510 workers with industrial accidents. Data were collected by personal interviews with structured questionnaires for three months from August to October in 2005. For analyses, frequencies and means were utilized. RESULTS: The participants' average age was 44.9 years, and about 91% of them were male. Also, they had a greater risk of poverty after being injured. The most frequent cause of accidents was fall (32.2%), and the most frequent injured body area was extremities (73.9%). For around a half of the participants, the treatment period was 12 months or shorter. The participants were at great risk of experiencing a negative impact due to events, depression, and anxiety. CONCLUSION: It is necessary to develop: (a) strategies for injured workers to be financially stable during recuperation; and (b) supporting systems for them not to suffer and exacerbate mental health problems after being injured.
Accidents, Occupational ; Anxiety* ; Depression* ; Extremities ; Humans ; Korea ; Male ; Mental Health ; Poverty ; Surveys and Questionnaires

OBJECTIVES: The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or an expectation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. METHODS: Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. RESULTS: Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVQUAL, R2=0.29; Non-Diff, R2=0.51; SERVPERF, R2=0.48) and purchase intention(SERVQUAL, R2=0.22; Non-Diff, R2=0.33; SERVPERF, R2=0.34). CONCLUSION: The major conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction be measured by the Non-Diff or SEVPERF scales.
Consumer Satisfaction* ; Delivery of Health Care* ; Humans ; Intention ; Questionnaires ; Weights and Measures

OBJECTIVES: To determine the relationships among quality, satisfaction, value and purchase intention in health care service. METHODS: The data were gathered from out-patients who had used hospital services. They were asked to assess service quality, satisfaction, service value, and purchase intention. A total of 557 usable questionnaires were gathered. The data were analyzed using SAS version 6.12. The analytic methods employed in the study were confirmatory analysis and covariance structural analysis. RESULTS: Service quality exhibited a significant and positive relationship with satisfaction, service value, and purchase intention. Furthermore, satisfaction had a significant and positive relationship with purchase intention. And finally, service value had a significant and positive relationship with both satisfaction and purchase intention. Based on these findings, it is evident that satisfaction was a mediator between service quality and purchase intention. Also service value played a mediating role between service quality and satisfaction. CONCLUSIONS: These results suggest that service quality is an antecedent of satisfaction and service value, and exerts a stronger influence on purchase intentions than satisfaction and service value do. Thus, managers may need to emphasize service quality in health care.
Delivery of Health Care* ; Humans ; Intention* ; Models, Structural* ; Negotiating ; Outpatients ; Surveys and Questionnaires

BACKGROUND: Assessment of programmed cell death-ligand 1 (PD-L1) immunohistochemical staining is used for treatment decisions in non-small cell lung cancer (NSCLC) regarding use of PD-L1/programmed cell death protein 1 (PD-1) immunotherapy. The reliability of the PD-L1 22C3 pharmDx assay is critical in guiding clinical practice. The Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists investigated the interobserver reproducibility of PD-L1 staining with 22C3 pharmDx in NSCLC samples.METHODS: Twenty-seven pathologists individually assessed the tumor proportion score (TPS) for 107 NSCLC samples. Each case was divided into three levels based on TPS: <1%, 1%–49%, and ≥50%.RESULTS: The intraclass correlation coefficient for TPS was 0.902±0.058. Weighted κ coefficient for 3-step assessment was 0.748±0.093. The κ coefficients for 1% and 50% cut-offs were 0.633 and 0.834, respectively. There was a significant association between interobserver reproducibility and experience (formal PD-L1 training, more experience for PD-L1 assessment, and longer practice duration on surgical pathology), histologic subtype, and specimen type.CONCLUSIONS: Our results indicate that PD-L1 immunohistochemical staining provides a reproducible basis for decisions on anti–PD-1 therapy in NSCLC.
Carcinoma, Non-Small-Cell Lung ; Cell Death ; Immunohistochemistry ; Immunotherapy ; Observer Variation ; Pathology

Intraosseous lipoma is a benign tumor that originates from proliferating mature lipocytes. It often occurs in the metaphysis of long bones of the lower extremity, and also in the calcaneus, humerus, mandible, sacrum, and rib bones. Frequently, it involutes spontaneously through a process of infarction, calcification, and cyst formation. It can either present as pain, or be asymptomatic and only discovered through an incidental radiological finding. In our case, the patient presented with heel pain. Intraoperatively, it was found that the intraosseous cavity was filled with fat along with an adjacent but separate area of cystic degeneration. There was also a cortical perforation at the cystic lesion which was communicating with the subtalar joint. This cortical breach is most likely the cause of diffuse lateral heel pain experienced by our patient, and such a pathological fracture due to intraosseous lipoma has never been reported.
Adipocytes ; Bone Neoplasms ; Calcaneus ; Fractures, Spontaneous ; Heel ; Humans ; Humerus ; Infarction ; Lipoma* ; Lower Extremity ; Mandible ; Ribs ; Sacrum ; Subtalar Joint