Vaccinia virus is the prototype orthopoxvirus that has been used as a vaccine strain for small pox. This virus has been used to express a variety of cellular and viral genes in mammalian cells at high levels. Interleukin-4 (IL-4) has been found to stimulate the proliferation of T cells and enhance the cytolytic activity of cytotoxic T lymphocytes. To test the immunotherapeutic potential of IL-4 delivered in vivo by poxvirus, a recombinant vaccinia virus expressing the murine IL-4 gene (RVVmIL-4) was constructed. A high level of IL-4 production was confirmed by infecting HeLa cells and measuring IL-4 in cell culture supernatant by ELISA. As a tumor model, two cell lines were used: the murine T leukemic line P388 and the murine breast cancer line TS/A. CDF1 mice were intraperitoneally inoculated with 1 x 105 cells of P388. Mice were injected at the same site with 5 x 105 PFU of recombinant vaccinia virus; first, 3 days after the injection of tumor cells and thereafter once every week for 3 weeks. Intraperitoneal injections of RVVmIL-4 significantly prolonged the survival time of mice inoculated with tumor cells. All mice injected with RVVmIL-4 remained alive for 30 days after the postinoculation of tumor cells, while 100% and 70% of the animals injected with saline or wild type vaccinia virus died, respectively. In another tumor model using TS/A, tumor was established by subcutaneously inoculating 2 x 105 tumor cells to BALB/c mice. After tumor formation was confirmed on day 4 in all mice, 5 x 106 PFU of RVVmIL-4 was inoculated subcutaneously three times, once every week for 3 weeks. The TS/A tumor was eradicated in two of the nine mice. Seven of the nine mice treated with RVVmIL-4 developed a tumor, but tumor growth was significantly delayed compared to those treated with saline or wild type vaccinia virus. These results indicate that recombinant vaccinia viruses may be used as a convenient tool for delivering immunomodulator genes to a variety of tumors.
Animals ; Breast Neoplasms ; Cell Culture Techniques ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Genes, Viral ; HeLa Cells ; Humans ; Injections, Intraperitoneal ; Interleukin-4* ; Interleukins* ; Mice ; Orthopoxvirus ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Vaccinia virus* ; Vaccinia*

OBJECTIVE: To determine the differences between the patient's and physicians' views of the effects of internet health information on the physician-patient relationship. METHODS: An online survey was carried out with 25 items developed by revising the questionnaire of Direct-to-Consumer Advertising to accommodate the internet health information. The respondents were 671 patients who were active participants in online patient communities and 493 physicians who were the professors of medical schools and practicing physicians. RESULTS: Most of the patients were positive toward the Internet Health Information saying that it gives them advice from a doctor with self-confidence, allows them to follow their doctor's directions well, obtain more medical treatment after retrieving the information, etc. In contrast, physicians perceived that the internet health information may have variety of negative effects, such as increasing the healthcare cost, unnecessary clinic visits and undermining of the doctor-patient relationship. There were significant differences in the perspectives between the physicians and patients. CONCLUSION: It will be necessary to ensure experts provide internet health information, which will have beneficial effects on the quality of care, physician-patient relationship, and health service utilization.
Ambulatory Care ; Surveys and Questionnaires ; Dietary Sucrose ; Health Care Costs ; Health Services ; Humans ; Internet ; Schools, Medical

OBJECTIVE: This study was carried out to obtain basic data required to plan and develop consumer-centered internet health information site for Korean population. METHODS: An internet survey was conducted on 5 internet patient community sites between 23 January and 5 February, 2007. A total of 958 surveys were completed and included in the study. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and stepwise logistic regression analysis using SPSS version 12.0. RESULTS: According to our logistic regression analysis, the more internet usage, foreign country residents, members of breast cancer internet community, any workers except sales, and higher level of necessity/usefulness/reliability showed a higher Odds ratio for frequency of internet health information usage. Educational status, frequency of using internet, importance, necessity, usefulness, reliability of internet health information (p<.001), income, and satisfaction of internet health information (p<.05) were statistically significant in the frequency of internet health information usage. CONCLUSION: Above characteristics should be considered for planning to develop consumer-centered internet health information portals.
Breast Neoplasms ; Commerce ; Consumer Health Information ; Consumer Satisfaction* ; Educational Status ; Humans ; Internet* ; Logistic Models ; Odds Ratio

OBJECTIVES: The objective of the study was to determine patient's views of the effects of internet health information on the doctor-patient relationship. METHODS: Online survey with 26 items was conducted which was developed by revising the questionnaire of Direct-to-Consumer Advertising to accommodate to the internet health information. Members of the active online patients communities were solicited by e-mail. RESULTS: Most of them gave an affirmative answer on Internet Health Information saying that it makes them get advice from doctor with self-confidence, follow their doctor's direction well, get more medical treatment after retrieving the information and so on. By contrast, physicians perceived that internet health information may have variety of negative effects according to the preceding research. CONCLUSIONS: There are the differences of perspectives between physicians and patients. Therefore it will be necessary to make the experts' intervention in the provision of internet health information, which will have good effects on quality of care, doctor-patient relationship, and health service utilization.
Electronic Mail ; Health Services ; Humans ; Internet ; Surveys and Questionnaires

OBJECTIVE: To define the healthcare information industry in order to propose a developmental direction for the industry, classify and analyze the healthcare information industry business models, and propose strategic guidelines for development of the healthcare information industry. METHODS: A survey was conducted to investigate the private companies that provide healthcare information. For in-depth investigation of the study subjects, they were categorized based on their means of service provision. Open colloquium participation requests were extended to the representative companies, and five open-colloquiums were held. Additional data were obtained through a structured questionnaire investigating the problems and complaints, followed by a discussion on strategies and future plans. RESULTS: Through a review of previous research on internet business model classification, four major model classification systems were chosen and the healthcare information business models were classified. Based on the composite opinions derived from the participating companies, policy guidelines were proposed. CONCLUSION: It is important to cooperate with experts from each field under governmental supervision and help the general public appreciate the value of healthcare information, thereby achieving the industrialization and development of the health information provision business.
Commerce ; Delivery of Health Care ; Internet ; Organization and Administration ; Surveys and Questionnaires ; Industrial Development

OBJECTIVE: The purposes of this research are to survey the consumers' opinions about the health information privacy, to understand the consumers' privacy.protective behaviors out of the concern about the privacy breaches, to know the consumers' recognition about the constitution of the health information privacy law, to know the consumers' willingness to share their personal medical information. METHODS: The questionnaire was developed and conducted by the California HealthCare Foundation on "National Consumer Health Privacy Survey" was translated into Korean and reviewed by the authors to conform to the Korean situation. We collected data from 335 on.line survey responses. RESULTS: Consumers concerned about the privacy of their personal health information. Consumers are unfamiliar with health information privacy law. Consumers think that the paper medical records are more secure than electronic medical records. Not so many Korean consumers practice the privacy.protective behaviors even though they worry about the misuse of the health information. However, consumers will share their personal medical information with limited others such as family members and physicians involved in their care. CONCLUSIONS: Most of the consumers answered that the information could be shared when necessary, however, the ownership and the right to decide the disclosure should belong to patient, and patient should be allowed to access their own information with certain degree of regulation.
California ; Constitution and Bylaws ; Consumer Health Information ; Delivery of Health Care ; Disclosure ; Electronic Health Records ; Humans ; Jurisprudence ; Medical Records ; Ownership ; Privacy* ; Surveys and Questionnaires

The occurrence of heterotopic tissue in the large intestine is unusual. The most common heterotopic tissue type described is gastric-type mucosa. On the other hand, heterotopic salivary gland tissue in the large intestine is extremely rare. To the best of the authors' knowledge, only five cases of heterotopic salivary gland in the large intestine have been reported, and all cases arose in the left colon. One out of five cases arose in the sigmoid colon, and the four other cases were found in the rectum-anal canal region. Endoscopically, they usually appeared as a polyp. The presentation of the patients was rectal bleeding or asymptomatic. Heterotopic salivary gland tissue in the colon has not been reported in Korea. This paper reports a case of heterotopic salivary gland tissue at the hepatic flexure of the colon and reviews the literature on similar cases. A 55-year-old male underwent large bowel endoscopy for colorectal carcinoma screening. The colonoscopy revealed five polyps. A sessile polyp at the hepatic flexure, 0.6 cm in size, was resected in a piecemeal manner. The histopathologic findings revealed a salivary gland with mixed mucinous-serous features and ducts. The other four polyps all were diagnosed as tubular adenoma with low-grade dysplasia.
Adenoma ; Choristoma ; Colon ; Colon, Sigmoid ; Colonoscopy ; Colorectal Neoplasms ; Endoscopy ; Hand ; Hemorrhage ; Humans ; Intestine, Large* ; Korea ; Male ; Mass Screening ; Middle Aged ; Mucous Membrane ; Polyps ; Salivary Glands*

BACKGROUND: The purpose of this study was to identify the attitude of physicians stemming from their experiences of caring for potential brain death donors during the organ donation process. METHODS: Grounded theory methodology was used for this study. In depth interviews were conducted with six physicians who had experience of management of potential brain death donors. Data collection was done from January to October 2011. Theoretical sampling was used until the data reached saturation. RESULTS: As a result of the analysis, dilemma of organ donation solicitation was identified as the core category. Twelve subcategories were identified and they were integrated to the core category. Obtaining organ donation counseling skills was identified as the consequence. CONCLUSIONS: The results of the study will provide a frame for understanding the attitudes stemming from their experience of caring for potential brain death donor and helping the development of effective intervention strategies for increasing organ donation.
Brain ; Brain Death ; Counseling ; Data Collection ; Humans ; Tissue and Organ Procurement ; Tissue Donors

OBJECTIVES: To explore the naturalistic outcome of the schizophrenics, we evaluated key clinical outcome-drop-out rate and readmission rate among the 33 risperidone and 17 conventional antipsychotics(such as haloperidol, chlorpromazine, mesoridazine) treated patients who met DSM-IV diagnostic criteria for schizophrenia at psychiatric department of a university hospital. METHOD: Outcome data was extracted from the charts of 50-schizophrenic patients who were more than 2 years after initiation of treatment with risperidone and conventional anti-psychotics. RESULTS: During over the 2-year period, the drop-out rate of the conventional antipsychotics treated schizophrenics was significantly higher than that of risperidone treated patients. But no significant factors(such as age, education level, duration of illness) were found between these two differently treated groups. Among the risperidone treated patients, the percentage of readmission was 18.2% at 12 months and 45.5% at 24 months. CONCLUSIONS: Reduced drop-out and rehospitalization rate suggest that risperidone was better than conventional antipsychotics among schizophrenic patients in a university hospital. Our data may contribute essential functional outcome information to assist the clinician in long-term, comparative treatment evaluation in 'real' clinical practice.
Antipsychotic Agents* ; Chlorpromazine ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Haloperidol ; Humans ; Outcome Assessment (Health Care)* ; Risperidone* ; Schizophrenia

Nodular fasciitis is a pseudosarcomatous reactive process composed of fibroblasts and myofibroblasts, and it is most common in the upper extremities. Nodular fasciitis of the external auditory canal is rare. To the best of our knowledge, less than 20 cases have been reported to date. We present a case of nodular fasciitis arising in the cartilaginous part of the external auditory canal. A 19-year-old man complained of an auricular mass with pruritus. Computed tomography showed a 1.7 cm sized soft tissue mass in the right external auditory canal, and total excision was performed. Histologic examination revealed spindle or stellate cells proliferation in a fascicular and storiform pattern. Lymphoid cells and erythrocytes were intermixed with tumor cells. The stroma was myxoid to hyalinized with a few microcysts. The tumor cells were immunoreactive for smooth muscle actin, but not for desmin, caldesmon, CD34, S-100, anaplastic lymphoma kinase, and cytokeratin. The patient has been doing well during the 1 year follow-up period.
Actins ; Calmodulin-Binding Proteins ; Desmin ; Ear ; Ear Canal* ; Erythrocytes ; Fasciitis* ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyalin ; Keratins ; Lymphocytes ; Lymphoma ; Muscle, Smooth ; Myofibroblasts ; Phosphotransferases ; Pruritus ; Upper Extremity ; Young Adult