PURPOSE: Early diagnosis is the primary method aimed at controlling breast cancer. The purpose of this study was to analyze some factors affecting the performance of mammography screening among women with a family history of breast cancer in Korea. METHODS: This study applied a descriptive design method through structured self-report questionnaires. The Care Seeking Behavior Theory provided a theoretical framework for the study. Factors measured in this study represent demographic, clinical, and psychosocial variables including anxiety, barriers, utility, habits, perception, and facilitators. A total of 212 participants, of at least 20 years old, were sampled from April 8, 2010 to March 31, 2011. The data was analyzed by logistic regression method using the Statistical Package for the Social Science 18.0 software. RESULTS: Of the 212 participants, 122 women (57.5%) went through mammography screening. The results of the analysis showed that (a) age (Odds Ratio [OR]=1.10, p<.001), (b) facilitating influences (OR=1.83, p=.008), (c) perception of mammography importance (OR=1.92, p=.011), (d) barriers to mammography (OR=0.60, p=.031), and (e) utility of mammography (OR=2.01, p=.050) significantly affect mammography screening. CONCLUSION: The results underscore the impact that psychosocial variables in obtaining mammography have on adherence to screening. Women with a family history of breast cancer should be given accurate information and recommendation about mammography by healthcare provider and a regular source of healthcare.
Anxiety ; Breast ; Breast Neoplasms ; Delivery of Health Care ; Early Detection of Cancer ; Early Diagnosis ; Female ; Health Behavior ; Health Personnel ; Humans ; Korea ; Logistic Models ; Mammography ; Mass Screening ; Surveys and Questionnaires ; Social Sciences ; Women's Health

A number of absurdities surrounding the humidifier disinfectant (HD) incident may have occurred because 1) a judicial system operates on the underlying false assumption that the involved parties are equals in knowledge, information and resource mobilization capabilities, regardless of respective real status as company or individual; 2) there is a lack of a system that mandates a company to prevent and actively manage possible catastrophes; 3) the regulatory scheme makes companies believe that as long as they are complying with the existing regulations, they have satisfied all of their responsibilities. I believe that this issue is an opportunity to bring about changes in the judicial redress system, the system of internal management of manufacturers, and the regulatory system of the government. The following regulation amendments are needed to move towards the changes stated above. First, legislation relating to victim relief that is applicable to the HD incident must be established. Second, a risk management system must be formed within the manufacturing company and to this end an institutional environment for the system must be established within regulatory framework. Furthermore, legislation must be passed that could punish companies themselves that have caused severe damage to individuals because they had failed to take necessary actions to avoid foreseeable harm. Finally, the framework of regulation must be changed so that the company, who has the necessary information regarding the product and the component chemicals used in the product, must self-directed experiment and assessment of the safety of their own products.
Humidifiers* ; Risk Management ; Social Control, Formal

OBJECTIVE: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease.METHODS: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro 2015™ (TreeAge Software, Inc, Williamstown, MA, USA).RESULTS: Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard.CONCLUSION: Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.
Cervical Vertebrae ; Cost-Benefit Analysis ; Female ; Humans ; Quality-Adjusted Life Years ; Retrospective Studies ; Spinal Fusion ; Spine ; Total Disc Replacement

BACKGROUND: As South Korea is becoming an aged society very rapidly, the increase in osteoarthritis prevalence raises various public health issues in this country. This study aimed to explore the socio-demographic factors associated with osteoarthritis in the current Korean elderlies. METHODS: Using the National Survey of Korean Elderly data (2014, 2017), we analyzed 20,326 elderlies (males, 8,248; females, 12,078) and conducted multivariate logistic regression analyses by sex. The dependent variable is whether a participant was diagnosed with osteoarthritis or not. Independent variables of interest is socio-demographic factors such as age, marital status, household type, residential area, household income, religion, the longest job, the number of close relatives, the number of close friends, and survey year. Control variables are various health behavioral factors and disease-related factors. RESULTS: Prevalence of osteoarthritis was 19.2% in male elderlies and 47.0% in female elderlies. According to the results of the multivariate logistic regression adjusted for all studied control variables, the odds ratio (OR) for having osteoarthritis of under-elementary school graduates (their counterpart was college graduate group) was 1.81 (95% confidence interval [CI], 1.29–2.52) in males and 1.67 (95% CI, 1.12–2.47) in females. The OR of those having a job in agriculture & forestry fishery as their longest job (their counterpart was those who had never participated in labor force during their lifetime) was 5.07 (95% CI, 1.46–17.58) in males and 1.49 (95% CI, 1.27–1.74) in females. In males, the second-low quartile group in household yearly income (their counterpart was the highest quartile group) had the OR of 1.22 (95% CI, 0.98–1.53). In females, the OR of those having a religion of Buddhism (their counterpart was those having no religion) was 1.20 (95% CI, 1.07–1.35) and the OR of those who had no relatives (their counterpart was those having more than 3 close relatives) was 1.31 (95% CI, 1.10–1.56). CONCLUSION This study found that in Korean elderlies, education, the longest job, household income, religion, and the number of close relatives are associated with their suffering from osteoarthritis. Further study and designing appropriate interventions are needed to alleviate current and future individual and socioeconomic burdens of osteoarthritis in an aged society like South Korea.

PURPOSE: Pedicled transverse rectus abdominis myocutaneous(TRAM) flap has been a gold standard for breast reconstruction and one of surgical techniques preferred by many surgeons. The authors examined the course of deep epigastric artery focusing on distance from margins of rectus abdominis to pedicle and location of choke vessels to get minimal muscles during pedicled TRAM flap operation. METHODS: Eleven rectus abdominis muscle from nine cadavers were used in this study. Rectus abdominis was separated from the cadavers, deep inferior and superior epigastric artery were isolated and then 8 anatomical landmarks in medial and lateral margins of rectus abdominis were designated. Distance to a pedicle meeting first horizontally was measured and vertical location from umbilicus to choke vessel was determined. In addition, 32 rectus abdominis images of 16 women(average age: 37.2 years old) from 64 channel abdomen dynamic computerized tomography were also examined with the same anatomical landmarks with those of cadavers. RESULTS: Average distance from four landmarks on lateral margin of rectus abdominis to pedicle was 1.9-3.4cm and 1.8-3.8 cm on medial margin. Choke vessel was located between middle and inferior tendinous intersection in all cases and average distance between two tendinous intersection was 6.7-7.0cm on medial margin and 6.2cm on lateral margin. Location of inferior tendinous intersection was on umbilicus or superior of it in all cases and its average distance from umbilicus was 1.8-5.6cm on medial margin and 2.7-6.2cm on lateral margin. CONCLUSION: Distance from medial and lateral margins of rectus abdominis muscle to pedicle was the shortest in inferior tendinous intersection and that was averagely 1.8cm on medial margin and 1.9cm in average on lateral margin. All choke vessels were located between middle and inferior tendinous intersection.
Abdomen ; Cadaver ; Epigastric Arteries ; Female ; Glycosaminoglycans ; Mammaplasty ; Muscles ; Rectus Abdominis ; Umbilicus

In July 2015, diseased leaves of black chokeberry (Aronia melanocarpa) were observed in Danyang and Gochang, Korea. The symptoms appeared as circular or irregular brown leaf spots, from which Alternaria tenuissima was isolated. The isolates were cultured on potato dextrose agar, and their morphological characteristics were observed under a light microscope. The colonies were whitish to ash colored. The pathogenicity test on healthy black chokeberry leaves produced circular brown spots, in line with the original symptoms. Molecular analyses of the ITS, GPD, RPB2, and TEF genes were conducted to confirm the identity of the pathogen. The phylogeny of the multi-gene sequences indicated that the causal agent was A. tenuissima. This study is the first report of A. tenuissima leaf spot on black chokeberry (A. melanocarpa).
Agar ; Alternaria* ; Glucose ; Korea* ; Photinia ; Phylogeny ; Solanum tuberosum ; Virulence

An inverted hyperplastic polyp (IHP) found in stomach is rare and characterized by downward growth of hyperplastic mucosal component into the submucosa. Because of such characteristic, IHP can be misdiagnosed as subepithelial tumor or malignant tumor. In fact, adenocarcinoma was reported to have coexisted with gastric IHP in several previous reports. Because only 18 cases on gastric IHP have been reported in English and Korean literature until now, pathogenesis and clinical features of gastric IHP and correlation with adenocarcinoma have not been clearly established. Herein, we report a case of gastric IHP which was initially misdiagnosed as gastrointestinal stromal tumor and resected using endoscopic submucosal dissection. Literature review of previously published case reports on gastric IHP is also presented.
Adult ; Gastric Mucosa/pathology/surgery ; Humans ; Hyperplasia/*diagnosis/diagnostic imaging ; Male ; Polyps/pathology/surgery ; Stomach/diagnostic imaging ; Stomach Neoplasms/diagnosis/diagnostic imaging/pathology ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVES: Inhalation exposure to humidifier disinfectants has resulted to various types of health damages in Korea. To determine the epidemiological correlation necessary for presuming the legal causation, we aimed to develop a method to synthesize the entire evidence. METHODS: Epidemiological and toxicological studies are systematically reviewed. Target health problems are selected by criteria such as frequent complaints of claimants. Relevant epidemiologic studies are reviewed and the risk of bias and confidence level of the total evidence are evaluated. Toxicological literature reviews are conducted on three lines of evidence including hazard information, animal studies, and mechanistic studies, considering the source-to-exposure-to-outcome continuum. The confidence level of the body of evidence is then translated into the toxicological evidence levels for the causality between humidifier disinfectant exposure and health effects. Finally, the levels of epidemiological and toxicological evidence are synthesized. RESULTS: Under the Special Act revised in 2020, if the history of exposure and the disease occurred/worsened after exposure were approved, and the epidemiological correlation between the exposure and disease was verified, the legal causation is presumed unless the company proves the evidence against it. The epidemiological correlation can be verified through epidemiological investigations, health monitoring, cohort investigations and/or toxicological studies. It is not simply as statistical association as understood in judicial precedents, but a general causation established by the evidence as a whole, i.e., through weight-of-the-evidence approach. CONCLUSIONS The weight-of-the-evidence approach differs from the conclusive single study approach and this systematic evidence integration can be used in presumption of causation.

Oral sulfate solution (OSS) is an emerging cleansing agent for bowel preparation. However, data comparing OSS to other conventional bowel preparations in Asian patients are limited. Therefore, the objective of this study was to compare the efficacy and tolerability of OSS to ascorbic acid plus polyethylene glycol (AA + PEG) in Asian patients. Methods: This was a prospective, randomized, parallel, investigator-blind study performed in two university hospitals in Korea. Bowel preparation efficacy was evaluated using both the Ottawa Bowel Preparation Scale (OBPS) and Boston Bowel Preparation Scale (BBPS). Results: Among 173 patients, 86 received OSS while 87 received AA + PEG for bowel preparation. Total OBPS score was 2.80 ± 2.48 in the OSS group and 4.49 ± 3.08 in the AA + PEG group, indicating significantly (p < 0.001) better efficacy with OSS. Total BBPS was higher in the OSS group (7.43 ± 1.49 vs. 6.51 ± 1.76, p < 0.001), indicating superior bowel preparation quality with OSS. Preparation-related adverse events were generally acceptable. Patients receiving OSS had more nausea (1.92 ± 0.94 vs. 1.54 ± 0.76, p = 0.004) and abdominal cramping (1.45 ± 0.78 vs. 1.17 ± 0.51, p = 0.006) than those receiving AA + PEG. However, overall satisfaction and taste were similar between the two groups. Conclusions: OSS had a non-inferior bowel cleansing efficacy than AA + PEG regardless of colon segment.

OBJECTIVE: We investigated the prevalence and risk factors of physically abusive behaviors (PhAB) and psychologically abusive behaviors (PsAB) towards people with dementia (PWD) in family caregivers, and compared their prevalences between East Asian and Western countries. METHODS: We estimated the prevalence and risk factors of PhAB and PsAB in 467 Korean pairs of community-dwelling PWD and their primary family caregivers. We evaluated abusive behaviors using the Modified Conflict Tactics Scale. In addition, we compared the prevalence of abusive behaviors between Asian and Western countries through a meta-analysis on 12 studies including the current one. RESULTS: More than a half of the caregivers reported PsAB and about one out of seven caregivers admitted PhAB within past three months. PsAB and PhAB were slightly more prevalent in East Asian countries than in Western countries. Non-Alzheimer type and moderate to severe behavioral and psychological symptoms of dementia were associated with the risk of PhAB but not with the risk of PsAB. Severe care burden and low income were associated with the risk of PhAB and PsAB. CONCLUSION: PhAB and PsAB were as prevalent in the family caregivers of PWD in Asian countries including Korea as in Western countries. Prevention strategies should be implemented according to the type of abusive behaviors.
Asian Continental Ancestry Group ; Caregivers* ; Dementia* ; Humans ; Korea* ; Prevalence* ; Risk Factors*